Arthroscopic-Assisted Lower Trapezius Tendon Transfer

The treatment of massive irreparable posterosuperior rotator cuff tears is especially difficult in relatively young population; in the absence of advanced glenohumeral arthritis, surgeons must be reluctant to offer the reverse shoulder replacement solution because of durability issues. Rotator cuff tears are considered irreparable when two or more tendons are involved and the retraction is up to the glenoid level and/or has fatty infiltration of more than 50% (Goutallier grade 3 or 4) [1, 2]; proximal migration of the humeral head is also considered a criteria for irreparability [3, 4].