Title : Arthroscopic assisted lower trapezius tendon transfer: Evidence-based rehabilitative approach
Abstract:
Massive irreparable posterior-superior rotator cuff tears present with challenges to definitive management in younger and more active patients who require not only pain relief but improved strength and durability of shoulder function. Arthroscopic-assisted lower trapezius tendon transfer (aa-LTT) has gained consideration in recent years as a viable and increasingly popular surgical option. This presentation will discuss the potential advantages of this surgical procedure compared to other surgical options. Biomechanical studies show that the lower fibres of trapezius has a better moment arm for external rotation as its line of pull is similar to the infraspinatus muscle. When restoration of force coupling between anterior and posterior rotator cuff is achieved, elevation of the extremity is re-established, allowing improved functional abilities. When a new surgical approach gains popularity, collaborative efforts between surgeon and physiotherapist allows for development of a protocol which respects the need for tissue healing and integrates the latest rehabilitation strategies for each phase of post-operative recovery. A systematic literature review strategy was employed to create a rehabilitation protocol that integrates best available evidence. The goals of each phase of aa-LTT rehabilitation will be discussed and a variety of exercises will be reviewed.
Audience Take Away:
- The indications for Arthroscopically Assisted Lower Trapezius Transfer (aa-LTT) and how it differs from other procedures performed for irreparable rotator cuff tears will be reviewed.
- An evidence based approach to shoulder rehabilitation development based upon the science of neuromuscular rehabilitation will be presented.
- Strategies to optimize goals attainment for each phase of recovery will be discussed.
