Does Teres Minor Trophicity Affect Outcomes After Arthroscopically-Assisted Lower Trapezius Tendon Transfer in Irreparable Posterosuperior Rotator Cuff Tears?

INTRODUCTION: The influence of teres minor (Tm) trophicity on outcomes after arthroscopically-assisted lower trapezius tendon (LTT) transfer for irreparable posterosuperior rotator cuff tears (PSRCTs) remains unclear. This study evaluated whether preoperative Tm trophicity affects postoperative pain, function, and range of motion (ROM).

METHODS: A retrospective review was conducted of consecutive patients who underwent arthroscopically-assisted LTT transfer between May 2017 and July 2022 for irreparable PSRCTs. Inclusion criteria were irreparable supraspinatus and infraspinatus tears confirmed intraoperatively with minimal glenohumeral arthritis. Patients were stratified into hypertrophic, normal, and hypotrophic Tm groups based on preoperative magnetic resonance imaging measurements. Clinical outcomes including Visual Analog Scale (VAS), Constant, and American Shoulder and Elbow Surgeons (ASES) scores, as well as active ROM, were assessed preoperatively and at final follow-up. Radiologic parameters, minimal clinically important difference (MCID), and complications were evaluated.

RESULTS: Of 119 eligible patients, 15 were excluded due to incomplete data (n=7) or loss to follow-up (n=8), leaving 104 patients for final analysis. Patients were classified into Tm hypertrophic (n=19), normal (n=72), and hypotrophic (n=13) groups. The mean follow-up duration was 45.3 ± 13.8 months (range, 24-84 months). All groups demonstrated significant postoperative improvements in VAS, Constant, and ASES scores (all p<0.001). Forward elevation, abduction, and external rotation improved significantly in all groups. Although the hypertrophic group showed greater preoperative external rotation, no significant intergroup differences were observed in postoperative clinical scores or ROM. All patients achieved MCID for VAS, and complication and retear rates were comparable among groups.

CONCLUSION: Arthroscopically-assisted LTT transfer is an effective joint-preserving procedure for patients with irreparable PSRCTs, resulting in significant improvements in pain, function, and ROM across all Tm trophicity groups. Although preoperative external rotation differed among Tm trophicity groups, no statistically significant differences were identified in postoperative clinical outcomes or retear rates. Larger studies are required to determine whether preoperative Tm trophicity influences postoperative function or structural healing.