Lower Trapezius Transfer for Massive Cuff Tear

Description

This video transcript details the surgical procedure for arthroscopic-assisted lower trapezius transfer for massive posterior-superior rotator cuff tears. It begins with patient positioning in a standard lateral decubitus position, ensuring proper exposure of the scapula with draping. The graft preparation includes soaking in vancomycin and making a 5 cm incision to access the lower trapezius muscle. Surgeons release the tendon from its attachment and prepare the graft by removing any bone and securing whip stitches for identification during the procedure.



The procedure progresses with arthroscopic access to debride scar tissue in the bursa, followed by creating passages for graft introduction under the deltoid. The graft is carefully marked to prevent twisting before introducing it into the subacromial space through designed sutures. Subsequently, pilot holes are created in the greater tuberosity to anchor the graft in place. The process includes the sequential securing of sutures using swivelock anchors, both for the medial and lateral aspects, while retaining some sutures to repair any remaining rotator cuff tissue.



Once the graft is adequately secured, excess material is trimmed, and a whip stitch is placed in the split graft for stabilization. This section integrates the graft with the lower trapezius tendon to enhance repair efficacy. Post-operatively, the patient is placed in an abduction sling for six weeks, followed by rehabilitation protocols to restore function.

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