The Orthobullets Podcast Podiums | Shoulder & Elbow | Lower Trapezius Transfer
Nov 2, 2025
Dr. Aaron Chamberlain, a shoulder and elbow specialist, offers an insightful dive into the lower trapezius transfer technique. He discusses its biomechanical advantages over latissimus dorsi for managing cuff deficiencies and shares clinical outcomes from his experience. Chamberlain outlines surgical steps, including open surgical techniques, graft harvesting, and arthroscopic methods, emphasizing patient selection criteria and recovery expectations. His expertise sheds light on this evolving surgical option, promising improved patient outcomes.
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Early WashU Experience With Lower Trap Transfers
- Dr. Aaron Chamberlain recounts early WashU cases showing 75% of lower trapezius transfers remained intact on ultrasound.
- He reports patients could consciously activate the transferred muscle during rehab despite initial weakness.
Lower Trap Matches Posterior Cuff Vector
- Biomechanical studies show lower trapezius restores kinematics better than latissimus dorsi for posterior cuff function.
- The transfer's vector and being in-phase likely explain its superior performance.
How To Find And Protect Lower Trap
- Use the hook test to identify and elevate the inferior lateral edge of the lower trapezius for harvest.
- Protect the dorsal scapular nerve which can lie within 1 cm of the medial scapular border when extending the incision.