Arthroscopy-Assisted Lower Trapezius Transfer Using Long Head of Biceps Tendon Autograft as an Interposition Graft for Massive Irreparable Rotator Cuff Tears (LHBT)

November 4, 2026 updated by: Mahmoud Mohamed Sayed Mahran, Al-Azhar University

The aim of the study is To evaluate the clinical, functional, and radiological outcomes of arthroscopically assisted lower trapezius tendon transfer using LHBT autograft as an interposition graft for massive irreparable rotator cuff tears., in terms of pain relief, shoulder range of motion, external rotation strength, patient-reported functional scores, and structural integrity of the transfer.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Massive rotator cuff tears represent a major cause of shoulder pain and disability among middle-aged and older patients. In younger, active patients with symptomatic massive irreparable tears, joint-preserving reconstructive procedures are generally favored over arthroplasty in order to maintain native anatomy and delay the need for prosthetic replacement. Tendon transfer of latissmus dorsi is preferered with autograft like Achillis tendon or semitendonosus tendon in this study we will use Long head of biceps tendon as interposition graft and evaluate the result clinicaly radiologicaly and functionaly postoperative

Study Type

Interventional

Enrollment (Estimated)

2

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

    • Asyut Governorate
      • Asyut, Asyut Governorate, Egypt, 71524
        • Al-Azhar University Hospital, Assiut

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria :

  • symptomatic massive posterosuperior rotator cuff tear (involving ≥2 tendons and/or ≥5 cm in the anteroposterior dimension) confirmed by MRI
  • Tear confirmed intraoperatively as irreparable despite maximal mobilization (medialized footprint repair not feasible)
  • Intact or repairable subscapularis tendon
  • Intact deltoid muscle function
  • Failure of at least 3-6 months of conservative treatment (physiotherapy, analgesics, activity modification) or prior failed rotator cuff repair
  • Preoperative active or passive forward elevation ≥ 0°-30° (i.e., not a pseudoparalytic shoulder with fixed loss of elevation, per surgeon's assessment) - to be defined per the surgical team's operative criteria
  • Available and functioning lower trapezius muscle and long head of biceps tendon on preoperative examination/imaging
  • Patient willing and able to comply with the postoperative rehabilitation protocol and scheduled follow-up visits

Exclusion criteria :

  • Advanced glenohumeral osteoarthritis (Hamada grade ≥ 3)
  • Irreparable subscapularis tear or anterosuperior tear pattern
  • Deltoid dysfunction, paralysis, or previous deltoid detachment
  • Lower trapezius dysfunction, atrophy, or prior denervation (e.g., spinal accessory nerve injury)
  • Long head of biceps tendon absent, previously ruptured, or already tenotomized/tenodesed
  • Axillary nerve palsy or brachial plexus injury
  • Active glenohumeral or periprosthetic infection
  • Uncontrolled systemic disease precluding surgery (e.g., uncontrolled diabetes mellitus, severe cardiopulmonary disease)
  • Inflammatory arthropathy of the shoulder
  • Previous ipsilateral shoulder arthroplasty
  • Patients unable or unwilling to give informed consent or to comply with follow-up

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Long head of biceps tendon autograft

We asses the outcomes of Arthroscopy-Assisted Lower Trapezius Transfer Using Long Head of Biceps Tendon Autograft as an Interposition Graft for Massive Irreparable Rotator Cuff Tears

Arthroscopy-Assisted Lower Trapezius Transfer Using Long Head of Biceps Tendon Autograft as an Interposition Graft for Massive Irreparable Rotator Cuff Tears

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
change in Constant-Murley Shoulder Score
Time Frame: 6 weeks, 3, 6,9,months and 1 year

The Constant-Murley Shoulder Score (CMS) is a 100-point combined subjective and objective scoring system designed to assess overall shoulder function:

Maximum Score: 100 points (indicates best possible shoulder function) Minimum Score: 0 points (indicates severe limitation/impairment)

6 weeks, 3, 6,9,months and 1 year

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Visual analog score VAS
Time Frame: 6 weeks, 3, 6,9,months and 1 year

psychometric response scale used to measure subjective pain intensity, including shoulder pain:

Standard Format: A 10 cm (100 mm) horizontal line anchored by two extreme descriptors at each end:

0 cm (0 mm): "No pain" 10 cm (100 mm): "Worst imaginable pain" (or "Worst pain ever felt")

6 weeks, 3, 6,9,months and 1 year

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

November 15, 2026

Primary Completion (Estimated)

November 15, 2027

Study Completion (Estimated)

November 15, 2028

Study Registration Dates

First Submitted

November 4, 2026

First Submitted That Met QC Criteria

November 4, 2026

First Posted (Actual)

November 9, 2026

Study Record Updates

Last Update Posted (Actual)

November 9, 2026

Last Update Submitted That Met QC Criteria

November 4, 2026

Last Verified

November 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • Azhar university Assiut

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

IPD Plan Description

Data will be available with a corresponding offer on reasonable request

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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