Archives of Orthopaedic and Trauma Surgery - 2026-05-07 - Journal Article; Comparative Study
Is biceps augmentation effective for scope-assisted lower trapezius tendon transfer in posterosuperior irreparable rotator cuff tears? A retrospective short-term clinical comparison.
Baek CH, Elhassan BT, Lim C, Kim JG, Kim BT, Kim SJ
Topics
Key Takeaway
Biceps augmentation added to scope-assisted lower trapezius tendon transfer (SALTT) for posterosuperior irreparable rotator cuff tears did not improve clinical outcomes and was associated with a significantly higher biceps rupture rate (p=0.019).
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Summary
This retrospective comparative study asked whether biceps tendon augmentation improves outcomes after SALTT for PSIRCTs. Both groups achieved significant improvements in VAS, PROMs, and active ROM at 2 years, but the non-augmentation group had significantly higher postoperative abduction (p=0.006) and external rotation (p=0.024). Biceps rupture rate was significantly higher in the augmentation group (p=0.019), with no between-group difference in MCID achievement or graft rupture rate.
Key Limitation
Retrospective non-randomized allocation of biceps augmentation introduces selection bias, as surgeons likely chose augmentation for anatomically or clinically distinct cases, confounding the outcome comparison.
Original Abstract
INTRODUCTION
Although favorable clinical outcomes of scope-assisted lower trapezius tendon transfer (SALTT) have been reported in posterosuperior irreparable rotator cuff tears (PSIRCTs) patients, the limited restoring of static stability can be supported by biceps augmentation as a static stabilizer. This study aimed to compare the outcomes of scope-assisted lower trapezius tendon transfer (SALTT) with and without biceps augmentation in patients with posterosuperior irreparable rotator cuff tears (PSIRCTs).
MATERIAL AND METHODS
This retrospective clinical comparative study was performed with the inclusion criteria: patients who underwent SALTT for PSIRCT from January 2022 to April 2023; a follow-up period of more than 2 years; and availability for clinical assessment and MRI evaluation preoperatively and at 2 years postoperatively. The patients were grouped according to the management of biceps; Non-augmentation group (n = 26) and Augmentation group (n = 27). The clinical outcomes were evaluated using shoulder pain, patient-reported outcome measures (PROMs), and active range of motion (aROM). Radiological outcomes were performed to evaluate the progression of shoulder joint arthritis, biceps integrity, and graft integrity.
RESULTS
Both groups showed significant improvements in VAS score, PROMs, and aROM. Although postoperative PROMs of Non-augmentation group were significantly higher than Augmentation group, there was no significant difference in achievement of minimal clinically important difference. The postoperative abduction (p = 0.006) and external rotation (p = 0.024) of Non-augmentation group were significantly higher than Augmentation group. Although the rate of transferred graft rupture was higher in Augmentation group, there was no significant difference between the two groups. However, the rate of biceps rupture of Augmentation group was significantly higher than Non-augmentation group (p = 0.019).
CONCLUSION
Biceps augmentation did not yield significant improvements in clinical or radiologic outcomes in SALTT for PSIRCTs. Moreover, it may be associated with increased rates of biceps rupture.
LEVEL OF EVIDENCE
Level III.