Is biceps augmentation effective for scope-assisted lower trapezius tendon transfer in posterosuperior irreparable rotator cuff tears? A retrospective short-term clinical comparison.

INTRODUCTION

Although favorable clinical outcomes of scope-assisted lower trapezius tendon transfer (SALTT) have been reported in posterosuperior irreparable rotator cuff tears (PSIRCTs) patients, the limited restoring of static stability can be supported by biceps augmentation as a static stabilizer. This study aimed to compare the outcomes of scope-assisted lower trapezius tendon transfer (SALTT) with and without biceps augmentation in patients with posterosuperior irreparable rotator cuff tears (PSIRCTs).

MATERIAL AND

METHODS

This retrospective clinical comparative study was performed with the inclusion criteria: patients who underwent SALTT for PSIRCT from January 2022 to April 2023; a follow-up period of more than 2 years; and availability for clinical assessment and MRI evaluation preoperatively and at 2 years postoperatively. The patients were grouped according to the management of biceps; Non-augmentation group (n = 26) and Augmentation group (n = 27). The clinical outcomes were evaluated using shoulder pain, patient-reported outcome measures (PROMs), and active range of motion (aROM). Radiological outcomes were performed to evaluate the progression of shoulder joint arthritis, biceps integrity, and graft integrity.

RESULTS

Both groups showed significant improvements in VAS score, PROMs, and aROM. Although postoperative PROMs of Non-augmentation group were significantly higher than Augmentation group, there was no significant difference in achievement of minimal clinically important difference. The postoperative abduction (p = 0.006) and external rotation (p = 0.024) of Non-augmentation group were significantly higher than Augmentation group. Although the rate of transferred graft rupture was higher in Augmentation group, there was no significant difference between the two groups. However, the rate of biceps rupture of Augmentation group was significantly higher than Non-augmentation group (p = 0.019).

CONCLUSION

Biceps augmentation did not yield significant improvements in clinical or radiologic outcomes in SALTT for PSIRCTs. Moreover, it may be associated with increased rates of biceps rupture.

LEVEL OF EVIDENCE: Level III.