Abstract

Purpose

The purpose of this study was to investigate the anatomical feasibility of a middle trapezius transfer below the acromion for treatment of irreparable supraspinatus tendon tears.

Methods

This study involved 20 human cadaveric shoulders in 10 full-body specimens. One shoulder in each specimen was dissected and assessed for muscle and tendon extent, force vectors, and distance to the neurovascular structures. The opposite shoulder was used to evaluate the surgical feasibility of the middle trapezius transfer via limited skin incisions along with an assessment of range of motion and risk of neurovascular injury following transfer.

Results

The harvested acromial insertion of the middle trapezius tendon showed an average muscle length of 11.7 ± 3.0 cm, tendon length of 2.7 ± 0.9 cm, footprint length of 4.3 ± 0.7 cm and footprint width of 1.4 ± 0.5 cm. The average angle between the non-transferred middle trapezius transfer and the supraspinatus was 33 ± 10° in the transversal plane and 34 ± 14° in the coronal plane. The mean distance from the acromion to the neurovascular bundle was 6.3 ± 1.3 cm (minimum: 4.0 cm). During surgical simulation there was sufficient excursion of the MTT without limitation of range of motion in a retracted scapular position but not in a protracted position. No injuries to the neurovascular structures were noted.

Conclusion

Transfer of the acromial portion of the middle trapezius for replacement of an irreparable supraspinatus seems to be feasible in terms of size, vector, excursion, mobility and safety. However, some concern regarding sufficiency of transfer excursion remains as scapula protraction can increase the pathway length of the transfer.

Level of evidence

Basic Science Study/Anatomical Study

Details

Title
Middle trapezius transfer for treatment of irreparable supraspinatus tendon tears- anatomical feasibility study
Author
Moroder Philipp 1 ; Akgün Doruk 1 ; Lucca, Lacheta 1 ; Thiele Kathi 1 ; Minkus Marvin 1 ; Maziak, Nina 1 ; Khakzad Thilo 1 ; Festbaum Christian 1 ; Rüttershoff Katja 1 ; Ellermann Sophia 1 ; Weiss, Torsten 2 ; Jöns, Thomas 2 ; Danzinger, Victor 1 

 Charité -Universitaetsmedizin Berlin, Department for Shoulder and Elbow Surgery, Center for Musculoskeletal Surgery, Campus Virchow, Berlin, Germany (GRID:grid.6363.0) (ISNI:0000 0001 2218 4662) 
 Charité -Universitaetsmedizin Berlin, Department for Anatomy, Institute for Functional Anatomy, Center for Surgical-anatomical Training, Berlin, Germany (GRID:grid.6363.0) (ISNI:0000 0001 2218 4662) 
Publication year
2021
Publication date
Jan 2021
Publisher
Springer Nature B.V.
e-ISSN
21971153
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2480025727
Copyright
© The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.