Quick Answer
Shoulder tendon transfer is an advanced reconstruction for selected irreparable massive rotator-cuff tears. A functioning muscle-tendon unit is redirected to compensate for a lost movement pattern. The goal is to restore force balance rather than recreate the torn tendon exactly.
Who May Be Considered?
Selection is critical. Age, activity goals, degree of glenohumeral arthritis, which cuff tendons are irreparable, deltoid function, external-rotation loss and previous surgery all matter. In patients with substantial arthritis, reverse shoulder arthroplasty may be more appropriate.
Which Transfers Are Used?
Depending on the tear pattern, options described include latissimus dorsi, lower trapezius and pectoralis major transfers. Current AAOS educational and appropriate-use materials include tendon transfer among selected reconstructive options for irreparable cuff tears; there is no single standard transfer for every patient.
Preoperative Assessment
MRI assesses tendon retraction, muscle atrophy/fatty infiltration and joint cartilage. Examination identifies the motion pattern that has been lost. Treatment should be discussed alongside alternatives such as partial repair, other reconstructions and arthroplasty.
Rehabilitation
Protected, staged rehabilitation is required while the transferred tendon heals and learns its new function. Recovery is measured in months and generally progresses from protected motion to controlled activation and strengthening according to the specific transfer.
Frequently Asked Questions
Will a tendon transfer make the shoulder completely normal?
No outcome can be guaranteed. The goal is meaningful improvement in pain and selected movements/function.
Can tendon transfer always replace reverse shoulder replacement?
No. Arthritis, age, muscle quality and functional goals determine which reconstruction is appropriate.
Sources
- AAOS OrthoInfo — Rotator Cuff Tears: Surgical Treatment Options
- AAOS Now — 2026 rotator-cuff Appropriate Use Criteria update
- PubMed — Lower trapezius tendon transfer for irreparable rotator cuff tears: systematic review (2025)
Evidence sources checked: 7 August 2026.
This page is for general patient education and does not replace an individual medical examination or treatment plan.