Improved Yet Varied Clinical Outcomes Observed - Comparison of Arthroscopic Superior Capsular Reconstruction Versus Arthroscopy-Assisted Lower Trapezius Transfer

Q: What was the study purpose comparing two surgical techniques?

The study evaluated outcomes of arthroscopic superior capsular reconstruction (SCR) versus arthroscopy-assisted lower trapezius tendon transfer (LTT) for posterosuperior irreparable rotator cuff tears.

Q: How were patients selected and which follow-up interval was required?

Patients who underwent IRCT surgery between October 2015 and March 2021 were identified, and only those with a minimum 12-month follow-up were included.

Q: Did SCR and LTT differ in patient-reported outcome scores after surgery?

No statistically significant differences were observed in patient-reported outcome scores at mean follow-up, though specific clinical measures differed between groups.

Q: Which technique showed better pain relief and forward elevation, and which improved external rotation more?

SCR provided better pain relief and improvements in forward elevation, while LTT offered more reliable improvement in external rotation.

Oct 19, 2026

Uploaded by Alex Sinclair

Evaluates outcomes of arthroscopic superior capsular reconstruction (SCR) and arthroscopy-assisted lower trapezius tendon transfer (LTT) for posterosuperior irreparable rotator cuff tears using a retrospective cohort comparison. Over October 2015 to March 2021, 32 SCR and 72 LTT patients with at least 12 months follow-up were assessed with VAS pain, strength measures, ASES, SANE, and QuickDASH. No between-cohort differences appeared in patient-reported outcomes at mean 2.9-year follow-up, while SCR improved pain and forward elevation and LTT improved external rotation.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Purpose

Methods

Results

Preoperative comparisons

Postoperative outcomes

Conclusions

Conflicts of interest and publication details

Improved Yet Varied Clinical Outcomes Observed With Comparison of Arthroscopic Superior Capsular Reconstruction Versus Arthroscopy-Assisted Lower Trapezius Transfer for Patients With Irreparable Rotator Cuff Tears Erick M. Marigi, M.D., Jacob R. Jackowski, M.D., Muhammad A. Elahi, B.A., Jonathan Barlow, M.D., Mark E. Morrey, M.D., Christopher L. Camp, M.D., and Joaquin Sanchez-Sotelo, M.D., Ph.D. Purpose: To evaluate the outcomes of arthroscopic superior capsular reconstruction (SCR) and arthroscopy-assisted lower trapezius tendon transfer (LTT) for posterosuperior irreparable rotator cuff tears (IRCTs) . Methods: Over an almost 6-year period (October 2015 to March 2021), all patients who underwent IRCT surgery with a minimum 12-month follow-up period were identiﬁed. For patients with a substantial active external rotation (ER) deﬁcit or lag sign, LTT was preferentially selected. Patient-reported outcome scores included the visual analog scale (VAS) pain score, strength score, American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) score, Single Assessment Numeric Evaluation (SANE) score, and Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score. Results: We included 32 SCR patients and 72 LTT patients. Preoperatively, LTT patients had more advanced teres minor fatty inﬁltration (0.3 vs 1.1, P ¼ .009), a higher global fatty inﬁltration index (1.5 vs 1.9, P ¼ .035), and a higher presence of the ER lag sign (15.6% vs 48.6%, P < .001) . At a mean follow-up of 2.9 􀀂 1.3 years (range, 1.0-6.3 years), no differences in patient-reported outcome scores were observed. Postoperatively, SCR patients had a lower VAS score (0.3 vs 1.1, P ¼ .017), higher forward elevation (FE) (156􀀃 vs 143􀀃 , P ¼ .004), and higher FE strength (4.8 vs 4.5, P ¼ .005) and showed greater improvements in the VAS score (6.8 vs 5.1, P ¼ .009), FE (56􀀃 vs 31􀀃 , P ¼ .004), and FE strength (1.0 vs 0.4, P < .001) . LTT patients showed greater improvement in ER (17􀀃 vs 29􀀃 , P ¼ .026) . There was no statistically signiﬁcant between-cohort difference in complication rate (9.4% vs 12.5%, P ¼ .645) or reoperation rate (3.1% vs 10%, P ¼ .231) . Conclusions: With adequate selection criteria, both SCR and LTT provided improved clinical outcomes for posterosuperior IRCTs. Additionally, SCR led to better pain relief and restoration of FE whereas LTT provided more reliable improvement in ER. Level of Evidence: Level III, treatment study with retrospective cohort comparison. See commentary on page 2142 Posterosuperior irreparable rotator cuff tears (IRCTs) are often characterized by various features including large tear size, advanced fatty inﬁltration, From the Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A. (E.M.M., J.R.J., J.B., M.E.M., C.L. C., J.S-S.); and Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, U.S.A. (M.A.E.) . The authors report the following potential conﬂicts of interest or sources of funding: J.B. receives intellectual property royalties from Stryker and is a paid consultant for Stryker, outside the submitted work. M.E.M. receives publishing royalties from Elsevier, outside the submitted work. C.L. C. receives nonconsulting fees from Arthrex and hospitality payments from Arthrex, Zimmer Biomet Holdings, and Gemini Medical, outside the submitted work. J.S-S. receives publishing royalties from Elsevier; is a paid consultant for Exactech, Precision OS, and Wright Medical Technology; owns stock or stock options in PSI; receives intellectual property royalties from Stryker and Wright Medical short tendon length, chronicity, and intraoperative inability to reattach the tendons to their footprint.1-7 The management of IRCTs remains challenging and is Technology; is a paid presenter for Stryker and Wright Medical Technology; and receives research support from Stryker, outside the submitted work Full ICMJE author disclosure forms are available for this article online, as

FAQs

What was the study purpose comparing two surgical techniques?

The study evaluated outcomes of arthroscopic superior capsular reconstruction (SCR) versus arthroscopy-assisted lower trapezius tendon transfer (LTT) for posterosuperior irreparable rotator cuff tears.

How were patients selected and which follow-up interval was required?

Patients who underwent IRCT surgery between October 2015 and March 2021 were identified, and only those with a minimum 12-month follow-up were included.

Did SCR and LTT differ in patient-reported outcome scores after surgery?

No statistically significant differences were observed in patient-reported outcome scores at mean follow-up, though specific clinical measures differed between groups.

Which technique showed better pain relief and forward elevation, and which improved external rotation more?

SCR provided better pain relief and improvements in forward elevation, while LTT offered more reliable improvement in external rotation.

Oct 19, 2026

Uploaded by Alex Sinclair