Lower trapezius transfer with Achilles tendon augmentation is used to treat patients with irreparable posterosuperior rotator cuff tears or for those with shoulder paralysis that impedes external rotation 1. This surgery uses the Achilles tendon to attach the lower trapezius tendon to the greater tuberosity of the humerus.
Promising clinical and radiographic outcomes have been seen for this surgery in functionally irreparable rotator cuff tears 2. Candidacy for this technique requires an intact or reparable subscapularis tendon, no advanced glenohumeral arthritis, and no humeral head femoralization.
This is the first reported case of Achilles tendon graft retraction from a lower trapezius transfer, proven on imaging. In this patient, the cause of lower trapezius transfer graft failure is unknown; there was no history of trauma. The patient is scheduled for right-reverse total shoulder arthroplasty.
Case co-contributor: Jason Lee (Loyola University).