{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T02:03:02Z","timestamp":1781316182861,"version":"3.54.1"},"reference-count":33,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["arthroscopyjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To compare the surgical outcomes of superior capsular reconstruction (SCR) combined with lower trapezius transfer (LTT) using an Achilles tendon allograft versus isolated SCR for the treatment of posterosuperior irreparable massive rotator cuff tears with severe infraspinatus fatty infiltration (Goutallier grades 3\u20104).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between 2016 and 2023, patients who underwent SCR\u2009+\u2009LTT or SCR alone for posterosuperior irreparable massive rotator cuff tears with severe infraspinatus fatty infiltration and had \u226524\u2010month follow\u2010up were retrospectively reviewed. Clinical evaluation included American Shoulder and Elbow Surgeons (ASES), Constant, visual analog scale (VAS) scores, and active external rotation (ER) were evaluated. Radiographs assessed the acromiohumeral distance, while magnetic resonance imaging at 3 and 12\u2009months evaluated graft integrity for all patients. The minimal clinically important difference (MCID) was calculated as half the standard deviation of score change from baseline to the latest follow\u2010up for the SCR group. The frequency of MCID achievements was then calculated in both groups, based on the SCR\u2010derived thresholds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty\u2010six patients were analyzed (SCR\u2009+\u2009LTT group, n\u2009=\u200915; SCR, n\u2009=\u200921) with a mean follow\u2010up time of 30.5\u2009\u00b1\u20096.9 and 36.5\u2009\u00b1\u20099.2\u2009months, respectively (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.067). The dataset was disaggregated by sex according to the Sex and Gender Equity in Research guidelines. Clinical and radiologic outcomes did not differ significantly between sexes, except for the preoperative Constant score, which was higher in the male group (male vs female: 60.4\u2009\u00b1\u20098.1 vs 54.4\u2009\u00b1\u20098.4,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.017). At the final follow\u2010up, SCR\u2009+\u2009LTT yielded superior ASES, Constant scores, lower VAS scores, and better ER than the SCR group (87.7\u2009\u00b1\u20095.0 vs 74.0\u2009\u00b1\u200918.3,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.042; 66.5\u2009\u00b1\u20094.3 vs 55.6\u2009\u00b1\u200912.5,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.004; 0.7\u2009\u00b1\u20090.6 vs 1.8\u2009\u00b1\u20091.6,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.033; and 47.3\u2009\u00b1\u200913.7 vs 36.0\u2009\u00b1\u200912.1,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.049, respectively). Graft tear rates were significantly lower in the SCR\u2009+\u2009LTT group compared with the SCR group\u00a0(13.3% vs 47.6%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.040), with greater acromiohumeral distance (7.9 vs 6.3\u2009mm,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.033). At 6\u2009months postoperatively, the SCR\u2009+\u2009LTT group showed higher ASES score, ER, and lower VAS scores than the SCR group (65.8\u2009\u00b1\u200913.7 vs 56.4\u2009\u00b1\u200913.6,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.036; 37.3\u2009\u00b1\u200915.3 vs 24.8\u2009\u00b1\u200917.9,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.036; and 1.0\u2009\u00b1\u20090.9 vs 3.5\u2009\u00b1\u20092.0,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001, respectively). The SCR\u2009+\u2009LTT group showed comparable MCID achievements for the ASES, Constant, VAS scores compared with the SCR groups (86.7% vs 66.7%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.252; 46.7% vs 33.3%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.449; 66.7% vs 71.4%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009&gt;.999, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Both SCR\u2009+\u2009LTT and SCR improved pain and function at \u226524\u2009months postoperatively in patients with posterosuperior irreparable massive rotator cuff tears with severe infraspinatus fatty infiltration. However, SCR\u2009+\u2009LTT provided superior clinical outcomes, greater ER restoration, lower graft tear rates, and comparable MCID achievements compared with isolated SCR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/arj.70129","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T07:35:38Z","timestamp":1776324938000},"page":"964-972","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Combined Superior Capsular Reconstruction and Lower Trapezius Transfer Using an Achilles Tendon Allograft Show Better Clinical Outcomes and Lower Graft Tear Rates Versus Isolated Superior Capsular Reconstruction for Chronic Posterosuperior Irreparable Massive Rotator Cuff Tears With Severe Fatty Infiltration in the Infraspinatus"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5139-8694","authenticated-orcid":false,"given":"Hui","family":"Ben","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Beijing Jishuitan Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0202-2671","authenticated-orcid":false,"given":"Jun\u2010Bum","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Asan Medical Center University of Ulsan College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6793-1860","authenticated-orcid":false,"given":"Hyun\u2010ki","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Asan Medical Center University of Ulsan College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9289-9193","authenticated-orcid":false,"given":"In\u2010Ho","family":"Jeon","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Asan Medical Center University of Ulsan College of Medicine  Seoul 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