Kim Bo Taek, Kim Jung Gon, Kim Seung Jin, Elhassan Bassem T, Baek Chang Hee
Department of Orthopaedic Surgery, Yeosu Baek Hospital, Yeosu, Republic of Korea.
Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.
Am J Sports Med. 2025 Jan;53(1):57-65. doi: 10.1177/03635465241298611.
Lower trapezius tendon (LTT) transfer has demonstrated promising results for patients with posterosuperior irreparable rotator cuff tears (PSIRCTs). However, there has been no study evaluating return to work (RTW) and return to sports (RTS) after LTT transfer.
PURPOSE/HYPOTHESIS: The purpose of this study was to assess the rates of RTW and RTS and identify associated factors among patients who have undergone LTT transfer for PSIRCTs. It was hypothesized that LTT transfer would result in favorable functional outcomes and high rates of RTW and RTS.
Case series; Level of evidence, 4.
A retrospective review was conducted on patients who underwent LTT transfer for symptomatic PSIRCTs with minimal glenohumeral arthritis. The clinical assessment included patient-reported outcome measures, testing of active range of motion, and a radiological evaluation of arthritis. Patients were surveyed on occupation, sports activity, RTW or RTS status, time to return, and degree of resumption of previous work and sports levels. Exclusion criteria included a follow-up period of <1 year, revision surgery, postoperative infections, loss to follow-up, and unavailability of data.
A total of 110 patients (mean age, 63.0 ± 6.9 years; mean follow-up, 35.3 ± 15.7 months) were included. Clinical scores and active range of motion significantly improved at the final follow-up, with no significant differences between the different work levels. For RTW, 93.6% (n = 103) returned to work (63.1% completely, 36.9% partially), with a mean time to return of 5.2 ± 1.7 months; 6.4% (n = 7) did not return. Patients with lighter work levels had higher return rates and quicker times to return than those with heavier work levels. For RTS, 90.7% (n = 86) returned to sports (70.5% completely, 29.5% partially), with a mean time to return of 5.7 ± 1.3 months. For patients who participated in shoulder sports, 89.9% returned, and 10.1% failed to return. Multivariable logistic regression showed significant associations of higher RTW rates with lighter work levels (odds ratio [OR], 2.72; = .005) and lower retear rates (OR, 5.41; = .021). A lower retear rate was also significantly associated with a higher RTS rate (OR, 7.66; = .010).
LTT transfer for PSIRCTs yielded favorable functional outcomes with high rates of RTW and RTS. Patient-related factors, notably work level and retears, influenced successful RTW and RTS.
下斜方肌腱（LTT）转移术已被证明在治疗后上不可修复性肩袖撕裂（PSIRCT）患者方面取得了令人满意的效果。然而，尚未有研究评估LTT转移术后的重返工作（RTW）和重返运动（RTS）情况。
目的/假设：本研究的目的是评估PSIRCT患者接受LTT转移术后的RTW和RTS率，并确定相关因素。假设LTT转移术将带来良好的功能结果以及较高的RTW和RTS率。
病例系列；证据等级，4级。
对因有症状的PSIRCT且肱盂关节炎轻微而接受LTT转移术的患者进行回顾性研究。临床评估包括患者报告的结局指标、主动活动范围测试以及关节炎的影像学评估。对患者进行职业、体育活动、RTW或RTS状态、返回时间以及先前工作和运动水平恢复程度的调查。排除标准包括随访期<1年、翻修手术、术后感染、失访以及数据不可用。
共纳入110例患者（平均年龄63.0±6.9岁；平均随访35.3±15.7个月）。在末次随访时，临床评分和主动活动范围显著改善，不同工作水平之间无显著差异。对于RTW，93.6%（n = 103）的患者重返工作（63.1%完全恢复，36.9%部分恢复），平均返回时间为5.2±1.7个月；6.4%（n = 7）未返回。工作水平较轻的患者返回率更高，返回时间比工作水平较重的患者更快。对于RTS，90.7%（n = 86）的患者重返运动（70.5%完全恢复，29.5%部分恢复），平均返回时间为5.7±1.3个月。对于参加肩部运动的患者，89.9%返回，10.1%未返回。多变量逻辑回归显示，较高的RTW率与较轻的工作水平（优势比[OR]，2.72；P = 0.005）和较低的再撕裂率（OR，5.41；P = 0.021）显著相关。较低的再撕裂率也与较高的RTS率显著相关（OR，7.66；P = 0.010）。
PSIRCT患者的LTT转移术产生了良好的功能结果，RTW和RTS率较高。患者相关因素，尤其是工作水平和再撕裂情况，影响了RTW和RTS的成功与否。
