Tendon transfers for irreparable rotator cuff tears: An update

Area of Science:

• Orthopedic Surgery
• Musculoskeletal Research
• Shoulder Reconstruction

Background:

• Shoulder dysfunction is common with irreparable rotator cuff tears (RCTs).
• Tendon transfer surgery is a viable treatment option for these complex cases.
• Various tendon transfer techniques exist, each with specific indications.

Purpose of the Study:

• To review current tendon transfer options for irreparable rotator cuff tears.
• To outline the indications and potential outcomes for different transfer procedures.
• To provide an update on managing shoulder dysfunction from RCTs.

Main Methods:

• Review of literature on tendon transfers for irreparable rotator cuff tears.
• Analysis of different surgical techniques including Latissimus dorsi, lower trapezius, pectoralis major, and pectoralis minor transfers.
• Evaluation of patient selection criteria and functional outcomes.

Main Results:

• Latissimus dorsi transfer is effective for posterosuperior RCTs in specific patient groups.
• Lower trapezius transfer shows promising anatomical results for posterosuperior RCTs.
• Pectoralis major and minor transfers can address isolated or combined subscapularis and supraspinatus tears.
• Reverse total shoulder arthroplasty combined with LDTMT benefits rotator cuff arthropathy with ER lag.

Conclusions:

• Tendon transfers are successful in treating shoulder dysfunction from irreparable RCTs.
• Patient-specific factors and tear patterns guide the choice of tendon transfer.
• These techniques offer valuable alternatives for managing complex rotator cuff pathology.