Open AccessMiddle trapezius transfer for treatment of irreparable supraspinatus tendon tears‐ anatomical feasibility study
Author(s) -
Moroder Philipp,
Akgün Doruk,
Lacheta Lucca,
Thiele Kathi,
Minkus Marvin,
Maziak Nina,
Khakzad Thilo,
Festbaum Christian,
Rüttershoff Katja,
Ellermann Sophia,
Weiss Torsten,
Jöns Thomas,
Danzinger Victor
Publication year - 2021
Publication title -
journal of experimental orthopaedics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 18
ISSN - 2197-1153
DOI - 10.1186/s40634-021-00326-1
Subject(s) - neurovascular bundle , medicine , cadaveric spasm , acromion , anatomy , cadaver , coronal plane , tendon , trapezius muscle , range of motion , tendon transfer , rotator cuff , supraspinatus muscle , shoulders , orthodontics , surgery , physical medicine and rehabilitation , electromyography
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