Table 2 Summarizes indications and contraindications of currently reported technique of middle trapezius tendon transfer; GH gleno-humeral, ISP infraspinatus, RC rotator cuff, SSC subscapularis, SSP supraspinatus

Indications:

*Irreparable RC tear with the following criteria:

-Clinical findings of persistent shoulder pain and/or pseudo-paralysis

-X-ray finding of decreased acromio-humeral distance (< 7 mm)

-MRI findings of > grade-II Patte retraction, > grade-II Goutallier fatty infiltration and > grade-II Thomazeau SSP muscle atrophy

-Intra-operative finding of poor soft tissue quality of torn tendon stump

*RC re-tear with the following 6–9 months postoperative criteria:

-Clinical findings of persistent shoulder pain and/or pseudo-paralysis

-Ultra-sound findings of RC non-vascularization, discontinuity and/or retraction on dynamic testing

-MRI findings of RC discontinuity and/or retraction

*Isolated supra-scapular nerve injury

Contraindications:

*Absolute contraindications:

-Advanced arthritis of GH joint

-Trapezius muscle paralysis

-Irreparable SSC

-Irreparable ISP

-Non-functioning deltoid muscle (e.g. dehiscence, axillary nerve injury)

-Active infection

*Relative contraindications:

-History of infection following RC repair

-Un-motivated patient for 6–9 months postoperative rehabilitation

-Elderly patients (i.e. > 65 years old)

-Shoulder stiffness