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Related Concept Videos

Muscles that Move the Arm01:31

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Nine muscles are involved in arm movements. Two of these, the pectoralis major and latissimus dorsi, originate from the axial skeleton and are called axial muscles. The other seven originate from the scapula and are called the scapular muscles.
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The muscles surrounding the shoulder girdle, including the clavicle and scapula, primarily stabilize the scapula. This stable base allows other muscles to move the humerus effectively. Scapular movements often mirror those of the humerus and extend its range of motion. For instance, raising the arm above the head would not be feasible without simultaneous upward rotation of the scapula.
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Return to work and sports after posterior latissimus dorsi transfer for posterior superior irreparable rotator cuff tears.

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Does prior rotator cuff surgery affect outcomes of posterior latissimus dorsi tendon transfer for irreparable posterosuperior tears?

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Related Experiment Video

Updated: Jan 1, 2026

Arthroscopic Management of Massive Irreparable Rotator Cuff Tears: Whole Rotator Cable Reconstruction Using Proximal Biceps Tendon Autograft
07:22

Arthroscopic Management of Massive Irreparable Rotator Cuff Tears: Whole Rotator Cable Reconstruction Using Proximal Biceps Tendon Autograft

Published on: June 6, 2025

484

Tendon transfers in rotator-cuff surgery.

Jean Kany1

  • 1Clinique de l'Union, 31240 Saint-Jean, France.

Orthopaedics & Traumatology, Surgery & Research : OTSR
|December 18, 2019
PubMed
Summary

Tendon transfer surgery offers new hope for irreparable rotator cuff tears, addressing various deficits beyond just external rotation. Specific transfers like latissimus dorsi and inferior trapezius are effective after primary surgery failure.

Keywords:
Irreparable rotator cuffMassive rotator cuff tearPseudoparalytic shoulderTendon transferTransfer with reverse prosthesis

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Area of Science:

  • Orthopedic surgery
  • Shoulder reconstruction
  • Rotator cuff pathology

Background:

  • Irreparable rotator cuff tears present complex challenges in restoring shoulder function.
  • Tendon transfer techniques have evolved, expanding their application beyond isolated external rotation deficits.
  • Understanding the biomechanics of the pseudoparalytic shoulder is crucial for surgical planning.

Purpose of the Study:

  • To review the indications and techniques for tendon transfer in irreparable rotator cuff tears.
  • To discuss the biomechanics of the pseudoparalytic shoulder and its implications for treatment.
  • To outline specific tendon transfers (latissimus dorsi, inferior trapezius, pectoralis major) and their optimal use cases.

Main Methods:

  • Review of current literature on tendon transfer for irreparable rotator cuff tears.
  • Analysis of biomechanical principles governing shoulder function after massive tears.
  • Description of surgical techniques for latissimus dorsi, inferior trapezius, and pectoralis major transfers.
  • Evaluation of indications based on specific functional deficits (elevation, internal/external rotation).

Main Results:

  • Tendon transfer is indicated for recurrent tears after failed conservative or primary surgical treatments.
  • Latissimus dorsi transfer is suitable for partial loss of elevation or isolated internal rotation deficit.
  • Inferior trapezius transfer is optimal for isolated external rotation deficits.
  • In severe pseudoparalytic shoulders, isolated transfers may be insufficient, requiring combination with reverse arthroplasty.

Conclusions:

  • Tendon transfer surgery is a viable and evolving option for managing irreparable rotator cuff tears.
  • Specific transfers address distinct functional deficits, offering tailored solutions.
  • Combined approaches, including reverse arthroplasty, may be necessary for comprehensive functional restoration in severe cases.