{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T08:43:50Z","timestamp":1782981830381,"version":"3.54.5"},"reference-count":29,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Journal of Sports Medicine"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Lower trapezius tendon (LTT) transfer can restore shoulder function, particularly active external rotation (ER) following massive rotator cuff tear (MRCT). However, the optimal graft type and its transfer location on the greater tuberosity remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To investigate the optimal graft type and location in LTT transfer for posterosuperior MRCT from a biomechanical perspective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Controlled laboratory study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Eight fresh-frozen cadaveric shoulders were tested on a shoulder simulator. LTT transfer was performed with an Achilles tendon fixed over the superior-middle facets (LTT-Achilles), a semitendinosus (ST) tendon to the superior facet (LTT-ST-S), or to the middle facet (LTT-ST-M). A 24-N load was applied to each transferred graft. Under each condition (intact rotator cuff, MRCT, LTT-Achilles, ST-S, and ST-M), humeral head translation and functional abduction force (FAF) were evaluated at 0\u00b0, 30\u00b0, and 60\u00b0 of glenohumeral elevation. ER torque was assessed across 5 angles (60\u00b0 internal rotation [60IR], 30\u00b0 internal rotation [30IR], neutral, 30\u00b0 ER [30ER], and 60\u00b0 ER [60ER]) at 0\u00b0, 30\u00b0, and 60\u00b0 of glenohumeral elevation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      None of the LTT conditions significantly depressed humeral head posterosuperior migration as compared with MRCT. Compared with MRCT, FAF improved significantly with LTT-Achilles at 0\u00b0 elevation (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .014) and LTT-ST-S at 0\u00b0 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) and 30\u00b0 elevation (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .003). LTT-ST-M improved ER torque compared with MRCT at 0\u00b0 elevation (60IR,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .04; 30IR,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .02; neutral,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .007; 30ER,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .03; 60ER,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .006) and at 30\u00b0 elevation (60IR,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .01; 30IR,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .02; neutral,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .006). LTT-ST-M showed higher ER torque than both LTT-Achilles and LTT-ST-S at 0\u00b0 elevation (30IR [LTT-Achilles,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .03; LTT-ST-S,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .04]; neutral [LTT-Achilles,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .02; LTT-ST-S,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .007]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In LTT transfer for MRCT, LTT-ST-M most effectively restored ER torque, whereas LTT-Achilles and LTT-ST-S improved FAF. None of the conditions of LTT transfer suppressed humeral translation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance:<\/jats:title>\n                    <jats:p>Graft selection and transfer location in LTT transfer can be tailored to patient goals and graft availability, leading to a more patient-specific surgical strategy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259671261436829","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T12:07:20Z","timestamp":1782734840000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["What Is the Optimal Graft and Transfer Location in Lower Trapezius Tendon Transfer for Posterosuperior Massive Rotator Cuff Tears? A Cadaveric Biomechanical Simulation Study"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6087-3434","authenticated-orcid":false,"given":"Ryosuke","family":"Iio","sequence":"first","affiliation":[{"name":"Roth McFarlane Hand and Upper Limb Centre, St Joseph's Health Care, London, Canada"},{"name":"Department of Orthopaedic Surgery, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cole T.","family":"Fleet","sequence":"additional","affiliation":[{"name":"Roth McFarlane Hand and Upper Limb Centre, St Joseph's Health Care, London, Canada"},{"name":"Department of Mechanical and Materials Engineering, Western University, London, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Roth McFarlane Hand and Upper Limb Centre, St Joseph's Health Care, London, Canada"},{"name":"Department of Mechanical and Materials Engineering, Western University, London, Canada"},{"name":"Department of Surgery, Western University, London, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George S.","family":"Athwal","sequence":"additional","affiliation":[{"name":"Roth McFarlane Hand and Upper Limb Centre, St Joseph's Health Care, London, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.xrrt.2025.06.006"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2023.09.013"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-022-04542-x"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2022.02.020"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465241235544"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2023.10.033"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2007.02.127"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/1758573220946257"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2023.06.029"},{"issue":"1","key":"e_1_3_3_11_2","first-page":"1","article-title":"Lower trapezius tendon transfer for irreparable rotator cuff injuries: a scoping review","volume":"3","author":"Desai V","year":"2022","unstructured":"Desai V, Stambulic T, Daneshvar P, Bicknell RT. 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