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Lower Trapezius Tendon Transfer Surgery in Durango, Colorado
Dr. Brian Butzen still remembers the frustration in his patient's voice. A rancher from Farmington had seen two other surgeons, and both told him the same thing: his rotator cuff tear was too far gone to fix. "They said I'd just have to live with it," the rancher recalled. But Dr. Butzen offered something different—a lower trapezius tendon transfer that could restore the shoulder function everyone else said was lost forever.
Since 2013, this double board-certified orthopedic surgeon has helped patients throughout Durango and the Four Corners region who thought they were out of options. As the only surgeon in the region performing this advanced procedure, Dr. Butzen has become the go-to specialist for complex rotator cuff problems that other surgeons can't address.
What is Lower Trapezius Tendon Transfer?
Lower trapezius tendon transfer is a procedure for patients whose rotator cuff tears are too severe for standard repair. When the rotator cuff muscles have pulled away from the bone and retracted too far—or when the muscle tissue has turned to fat and can no longer function—traditional surgery won't work. The tendon simply can't be reattached.
Think of your rotator cuff like the cables on a suspension bridge. When those cables snap and fray beyond repair, you need a different solution. Lower trapezius tendon transfer takes a healthy tendon from your back (the lower trapezius) and moves it to your shoulder to do the job your damaged rotator cuff can no longer do.
"This isn't a compromise surgery," explains Dr. Butzen from his practice at Animas Orthopedic Associates. "For the right patient, it can restore shoulder function that was thought to be permanently lost. People who couldn't lift their arm above their head are back to reaching overhead, throwing, and doing the activities they love."
The procedure works especially well for tears involving the posterior (back) part of the rotator cuff—the infraspinatus and teres minor tendons. These muscles help you rotate your arm outward and stabilize your shoulder during overhead movements.
Why Patients Choose Dr. Butzen for Lower Trapezius Tendon Transfer
The Only Surgeon in the Four Corners Offering This Procedure
Lower trapezius tendon transfer requires specialized training and experience that few surgeons have. Dr. Butzen is the ONLY surgeon in the entire Four Corners region—including Durango, Farmington, Cortez, and Pagosa Springs—who performs this advanced procedure. Without him, patients would need to travel to Denver, Albuquerque, or beyond for this surgery.
Double Board-Certified Expertise
Dr. Butzen holds board certifications from the American Board of Orthopedic Surgeons in both orthopedic surgery AND hand surgery. This dual certification reflects the highest standards in surgical training—something few surgeons in the region can claim.
100+ Shoulder Replacements Annually
Dr. Butzen performs over 100 reverse total shoulder replacements every year, making him the highest-volume shoulder surgeon in the Four Corners region. This experience with complex shoulder reconstruction translates directly to expertise in tendon transfer procedures.
Fellowship-Trained Upper Extremity Specialist
After completing his orthopedic residency, Dr. Butzen pursued additional fellowship training focused specifically on hand and upper extremity surgery. This extra year of specialized education means he understands shoulder biomechanics at the deepest level.
Direct Access to Your Surgeon
Unlike many practices where you communicate through staff, Dr. Butzen gives patients his direct email and cell phone. Questions about your recovery? Text him. Concerned about something after hours? He's available. This level of access is rare in medicine.
Animas Surgical Hospital Advantage
Dr. Butzen performs lower trapezius tendon transfer at Animas Surgical Hospital, which consistently earns the highest patient satisfaction ratings in the Durango area. The facility's focus on orthopedic procedures means better equipment, experienced surgical teams, and smoother recoveries.
Over a Decade Serving the Four Corners
Since 2013, Dr. Butzen has treated thousands of shoulder problems throughout Durango, Farmington, Cortez, and Pagosa Springs. He understands the local lifestyle and tailors treatment to get you back to your life. Read some of his patient testimonials here.
Who Needs Lower Trapezius Tendon Transfer?
Not every rotator cuff tear—even a large one—requires this procedure. Dr. Butzen carefully evaluates each patient to determine the best approach.
Massive Retracted Tears
When the rotator cuff tendon has pulled back too far from the bone, it can't be stretched back into place. The tissue has shortened and scarred down, making reattachment impossible.
Fatty Infiltration of the Muscle
Over time, a torn rotator cuff muscle can turn from healthy red muscle tissue into white fatty tissue. This process is called fatty infiltration. Once it happens, the muscle can't generate force even if the tendon is reattached. It's like trying to pull a rope attached to a deflated balloon.
Failed Previous Rotator Cuff Surgery
Some patients have had rotator cuff repair that didn't heal or re-tore. When the tissue quality is too poor for another repair attempt, tendon transfer offers a different path forward.
Chronic Tears with Severe Weakness
Patients who have lived with a rotator cuff tear for years may develop irreversible muscle damage. If you can't lift your arm away from your body or rotate it outward, and imaging shows the muscle is no longer functional, tendon transfer may be your best option.
The Ideal Candidate
Dr. Butzen looks for patients who:
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Have good function of their deltoid muscle (the muscle on the outside of your shoulder)
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Have a functioning lower trapezius muscle in their back
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Are motivated to participate in rehabilitation
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Have realistic expectations about recovery
"This surgery isn't for everyone," Dr. Butzen notes. "But for the right patient, it can be life-changing. I've seen people go from being unable to feed themselves to returning to work and hobbies they thought were gone forever."
What Happens During Lower Trapezius Tendon Transfer Surgery?
Lower trapezius tendon transfer is performed under general anesthesia at Animas Surgical Hospital in Durango. The surgery typically takes 2-3 hours.
The Surgical Process
Preparing the Shoulder
This portion of the surgery is done arthroscopically, with small incisions and a small camera inserted into the shoulder. Through small incisions to bring instruments in the shoulder, and the camera to visualize it, the bone is prepared. If a portion of the rotator cuff can be repaired adjacent to the transfer site, it is.
Using a Graft
Because the lower trapezius tendon isn't quite long enough to reach on its own, Dr. Butzen uses a tendon graft (usually from a donor) to bridge the gap. This graft heals into both the transferred tendon and the bone, creating a strong connection. It is first attached to the humerus bone with anchors
Harvesting the Tendon
Dr. Butzen makes an incision along your shoulder blade to access the lower trapezius tendon. This tendon is detached from its normal attachment point while preserving its blood supply and nerve connection—critical for the transferred tendon to survive and function.
Why Experience Matters
This surgery requires precise understanding of shoulder biomechanics. The transferred tendon must be positioned and tensioned exactly right, or it won't function properly. Dr. Butzen's experience with over 100 complex shoulder surgeries annually gives him the expertise to get these details right.
The Real Recovery Timeline
Dr. Butzen believes in giving patients realistic expectations about lower trapezius tendon transfer recovery. This is a major surgery, and healing takes time.
First 10 Weeks: Protection Phase
Your arm will be in a sling full-time. The transferred tendon needs time to heal into its new location, and any stress could disrupt that process. You will start physical therapy, but will be limited to passive motion only.
Weeks 10-14: Early Motion
The sling comes off, and gradually more and more use is allowed. You'll progress from passive to active-assisted exercises and then active exercises. The goal is to restore range of motion without stressing the healing tendon.
Months 3-6: Strengthening
Now the real work begins. Physical therapy focuses on strengthening the transferred tendon and retraining your brain to use it. This is a different muscle doing a new job, so your nervous system needs time to adapt.
Months 6-12: Return to Activities
Most patients see significant improvement by 6 months, but full recovery often takes a year. Dr. Butzen works with each patient to determine when they can return to specific activities based on their progress.
"I know six weeks in a sling sounds like a long time," Dr. Butzen tells his patients. "But this is the most important phase. We're giving your body time to build a strong connection."
Common Concerns About Lower Trapezius Tendon Transfer
Will I lose function in my back?
The lower trapezius is one of several muscles that move your shoulder blade. Taking this tendon doesn't cause noticeable weakness or problems with back function. Most patients never notice any difference.
How does this compare to reverse shoulder replacement?
Both procedures can help patients with irreparable rotator cuff tears, but they work differently. Reverse shoulder replacement is a joint replacement that changes the mechanics of your shoulder. Lower trapezius tendon transfer preserves your natural joint. Dr. Butzen evaluates each patient to determine which option is best for their situation. For some patients, tendon transfer is preferred because it preserves the option for joint replacement later if needed.
What if the transfer doesn't heal?
Like any surgery, there's a risk the transferred tendon won't heal properly. Dr. Butzen minimizes this risk through careful surgical technique and a structured rehabilitation protocol. Following the post-operative instructions—especially the sling wear during the first six weeks—is critical for success.
Will I regain full strength?
Most patients regain significant function, but the transferred tendon may not be quite as strong as a healthy rotator cuff. The goal is to restore enough function for daily activities and the things you enjoy. Many patients exceed their expectations.
Can I still have shoulder replacement later if needed?
Yes. One advantage of tendon transfer over some other procedures is that it preserves your options. If you develop shoulder arthritis years later, you can still have a shoulder replacement.
How long until I can drive?
Most patients can drive once they're out of the sling, around 10 weeks after surgery.
Why Not Just Live With It?
Some patients wonder if they should just accept their shoulder limitations rather than undergo major surgery. Dr. Butzen respects this choice but wants patients to understand what they're accepting.
An irreparable rotator cuff tear typically gets worse over time, not better. The shoulder becomes weaker. The remaining muscles fatigue from compensating. Arthritis can develop in the joint. Activities that are difficult now may become impossible later.
"I've had patients tell me they can live with not being able to reach overhead," Dr. Butzen says. "But then they realize they can't wash their hair, can't put dishes away, can't hug their grandchildren properly. These 'small' losses add up."
Lower trapezius tendon transfer offers a chance to regain function that was thought to be permanently lost. For active people in the Four Corners region—where life involves reaching, lifting, and using your arms—that function matters.
The Durango Advantage for Complex Shoulder Surgery
Getting your lower trapezius tendon transfer in Durango means you don't have to travel hours for expert care. Dr. Butzen's practice provides:
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The only surgeon in the Four Corners performing this procedure
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Coordination with physical therapists experienced in tendon transfer rehabilitation
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Follow-up care close to home throughout your recovery
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Access to Animas Surgical Hospital's excellent surgical team
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If you've been told your rotator cuff tear can't be fixed, don't give up. Lower trapezius tendon transfer may offer the solution you've been looking for.
Dr. Butzen's approach combines technical expertise with genuine care for his patients. His years of experience in Durango have taught him that successful treatment goes beyond just fixing the problem—it's about understanding how the injury affects your life and helping you get back to living it fully.
The mountains and mesas of the Four Corners region offer endless opportunities for adventure. Don't let an "irreparable" rotator cuff tear keep you on the sidelines. Expert lower trapezius tendon transfer surgery is available right here in Durango, helping you get back to the activities that make this area such a special place to live.
If you've suffered a shoulder injury, don't wait to get it evaluated. What seems like a simple shoulder problem could be a rotator cuff tear that needs treatment.
Dr. Butzen's approach combines technical expertise with genuine care for his patients. His years of experience in Durango have taught him that successful treatment goes beyond just fixing the tendon—it's about understanding how the injury affects your life and helping you get back to living it fully.
The mountains and mesas of the Four Corners region offer endless opportunities for adventure. Don't let a wrist injury keep you on the sidelines longer than necessary. Expert rotator cuff surgery is available right here in Durango, helping you get back to the activities that make this area such a special place to live.
Take the first step toward expert care and lasting relief