Irreparable Rotator Cuff Tears: Restoring Joint Kinematics by Tendon Transfers

Joshua A. Greenspoon1, Peter J. Millett1, *, Samuel G. Moulton2, Maximilian Petri1
1 Steadman Philippon Research Institute, 181 West Meadow Drive, suite 1000 Vail, CO, 81657, USA
2 The Steadman Clinic, 181 West Meadow Drive Vail, CO, 81657, USA

Article Metrics

CrossRef Citations:
Total Statistics:

Full-Text HTML Views: 1053
Abstract HTML Views: 422
PDF Downloads: 276
ePub Downloads: 213
Total Views/Downloads: 1964
Unique Statistics:

Full-Text HTML Views: 686
Abstract HTML Views: 271
PDF Downloads: 208
ePub Downloads: 171
Total Views/Downloads: 1336

Creative Commons License
© Greenspoon et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address corresponding to this author at the Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 1000 Vail, CO, 81657, USA; E-mail:



Tendon transfers can be a surgical treatment option in managing younger, active patients with massive irreparable rotator cuff tears. The purpose of this article is to provide an overview of the use of tendon transfers to treat massive irreparable rotator cuff tears and to summarize clinical outcomes.


A selective literature search was performed and personal surgical experiences are reported.


Latissimus dorsi transfers have been used for many years in the management of posterosuperior rotator cuff tears with good reported clinical outcomes. It can be transferred without or with the teres major (L’Episcopo technique). Many surgical techniques have been described for latissimus dorsi transfer including single incision, double incision, and arthroscopically assisted transfer. Transfer of the pectoralis major tendon is the most common tendon transfer procedure performed for anterosuperior rotator cuff deficiencies. Several surgical techniques have been described, however transfer of the pectoralis major beneath the coracoid process has been found to most closely replicate the force vector that is normally provided by the intact subscapularis.


Tendon transfers can be used successfully in the management of younger patients with massive irreparable rotator cuff tears and minimal glenohumeral arthritis. Improvements in clinical outcomes scores and range of motion have been demonstrated. This can delay arthroplasty, which is of particular importance for younger patients with high functional demands.

Keywords: Irreparable rotator cuff tear, Latissimus dorsi tendon transfer, Massive rotator cuff tear, Pectoralis major tendon transfer, Rotator cuff tear, Tendon transfer.