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Comparative Outcomes and Complication Rates of Lower Trapezius Versus Latissimus Dorsi Tendon Transfer for Irreparable Posterosuperior Rotator Cuff Tears: A Systematic Review
Journal article   Open access   Peer reviewed

Comparative Outcomes and Complication Rates of Lower Trapezius Versus Latissimus Dorsi Tendon Transfer for Irreparable Posterosuperior Rotator Cuff Tears: A Systematic Review

Ross Clarke, Brian S. Tao, Peter Boufadel, Mohammad Abdelaal, Neal Shah, Abhishek Suresh, Brian R. Waterman, Joseph W. Galvin, Josef K. Eichinger and Xinning Li
JSES reviews, reports, and techniques, 100841
08/2026
DOI: 10.1016/j.xrrt.2026.100841
url
https://doi.org/10.1016/j.xrrt.2026.100841View
Published (Version of record) Open Access

Abstract

Latissimus dorsi transfer (LDT) and lower trapezius transfer (LTT) for irreparable posterosuperior rotator cuff tears have been shown to have favorable outcomes. There has been no systematic comparison of clinical outcomes between the two techniques. We aimed to compare clinical outcome measures, complications, and rates of conversion to reverse shoulder arthroplasty (rTSA) between LDT and LTT with a minimum of 1-year postoperative follow-up. We performed a systematic review using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, querying MEDLINE (PubMed) and EMBASE databases for studies reporting outcomes and complications following LDT and LTT with a minimum of 1-year follow-up. We assessed the methodological quality of each study using the MINORS score and extracted patient demographics, clinical, and patient-reported outcome data. Sixty-nine studies, including 2,476 patients (2,495 shoulders), met the inclusion criteria. The LDT and LTT groups consisted of 1,834 and 661 shoulders, respectively. The weighted mean age (+/- standard deviation) was 60.2 ± 4.1 years, follow-up was 49.2 ± 23.7 months, and 33.4% were female. Compared with LTT, LDT group showed a greater improvement in the Constant (28.9 vs 23.6, p<0.01), UCLA scores (15.1 vs 8.5, p=0.03), and lower VAS scores for pain (-4.4 vs -3.3, p=0.02). LTT group gained more active external rotation (21.9° vs 15.2°, p<0.01) compared to the LDT group. Active forward elevation, active abduction, ASES and ADLER scores, patient satisfaction, complication rates, and conversion rates to rTSA were similar between groups, with the exception of a higher incidence of nerve injury in the LDT group (0.8% vs 0%, p<0.01). Both LDT and LTT are viable options for irreparable posterosuperior rotator cuff tears. While differences in reported outcomes were observed across studies—such as greater improvements in external rotation in LTT cohorts and slightly higher improvements in certain patient-reported outcomes in LDT cohorts—these findings are derived from indirect comparisons of heterogeneous populations and should be interpreted with caution.
 clinical outcomes latissimus dorsi lower trapezius range of motion rotator cuff tears Tendon transfer

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