Tendon transfer for massive rotator cuff tears: A narrative review

Area of Science:

• Orthopedic Surgery
• Biomechanical Engineering
• Reconstructive Surgery

Background:

• Tendon transfer is vital for irreparable rotator cuff tears (IRCTs) and nerve dysfunction when direct repair fails.
• It restores shoulder stability and function by reattaching tendons to compensate for lost muscle activity.
• Common techniques include latissimus dorsi (LD), teres major (TM), lower trapezius (LT), pectoralis major (PM), and middle trapezius (MT) transfers.

Purpose of the Study:

• To review the fundamental concepts of tendon transfer in shoulder reconstruction.
• To discuss indications, biomechanical principles, clinical outcomes, and potential complications.
• To emphasize the importance of patient selection, surgical technique, and rehabilitation for optimal results.

Main Methods:

• Review of existing literature on tendon transfer procedures for shoulder conditions.
• Analysis of biomechanical strategies and clinical outcomes reported in various studies.
• Identification and categorization of common complications associated with tendon transfers.

Main Results:

• Tendon transfers effectively restore shoulder function in cases of IRCTs and nerve injuries.
• Specific transfers (LD, LT, PM, MT) are indicated based on tear location and extent.
• Dual tendon transfers offer solutions for complex cases with extensive muscle deficits.
• Complications include neurovascular injury, infection, tendon rupture, and altered biomechanics due to improper tensioning.

Conclusions:

• Tendon transfer is a valuable reconstructive option for complex shoulder pathologies.
• Meticulous patient selection, precise surgical execution, and structured rehabilitation are crucial.
• Understanding biomechanics and potential complications is essential for successful shoulder reconstruction and functional recovery.