MRI
What part of the humerus does the Achilles tendon attach to in a lower trapezius transfer?
The Achilles tendon is attached to the greater tuberosity of the humerus in a lower trapezius transfer.
For what indications would a lower trapezius transfer be considered?
Lower trapezius transfer would be considered for irreparable posterosuperior rotator cuff tears or for shoulder paralysis which impedes external rotation.
Which tendon must be intact (or reparable) for a lower trapezius transfer to be considered as a treatment option for functionally irreparable rotator cuff tears?
An intact or reparable subscapularis tendon is required for a lower trapezius transfer to be performed.
To which tendon does the Achilles tendon attach in a lower trapezius transfer?
The Achilles tendon attaches to the lower trapezius tendon.
MR arthrogram of the right shoulder shows a thick linear hypointense structure at the posterior aspect of the shoulder, consistent with an Achilles tendon allograft. The calcaneal side of the Achilles tendon is lateral in this case and does not seem attached to the suture anchors or have greater tuberosity, consistent with graft tear/non-healing with retraction. There are full-thickness tears in the native supraspinatus and infraspinatus tendons. Severe atrophy of the infraspinatus muscle is seen. The teres minor and subscapularis tendons are intact. Biceps tenodesis is noted. Contrast is present in the glenohumeral joint, subacromial subdeltoid bursa, and acromioclavicular joint.