Lower Trapezius Transfer (Achilles tendon +/- bone allograft)

Lower Trapezius Transfer with Achilles tendon +/- calcaneal bone block allograft is designed to restore shoulder function for patients who sustained massive irreparable rotator tears. 

Initial Phase – post op to 6-8 weeks

§ Immobilised shoulder in abduction brace (45 abduction and 30 external rotation) for 6/52 (up to 8/52 depending on surgeon’s orders)

§ Passive shoulder ROM exercises above brace maybe allowed 

§ Encourage Cx spine, elbow, wrist and finger ROM

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Appt: At discharge, please refer the patient for physiotherapy follow‑up at the appropriate location. For physiotherapy at the PAH, organise an appointment approximately 2 weeks post‑operation. If the patient is clearly very competent with their exercises and is achieving near the allowed range of motion, you may consider delaying the appointment until 6–8 weeks post‑operation when the ROM orders change. (Please still send the referral through.)

Rehab Phase – 6 to 12 weeks

§ Commence periscapular activation 

§ Commence shoulder active ROM with avoidance of lower trap activation (external rotation)

Functional Phase – 12 weeks+

§ Upon confirmation of allograft bone union on CT scan, patient can commence specific coupling shoulder abduction and external rotation with scapular retraction ex’s

§ Commence strengthening (light to begin with)

>> 6 months+

§ Return to sporting activities