What are Anterior and Posterior Tendon Transfers for rotator cuff tears?
Anterior and posterior tendon transfers are surgical procedures that involve moving a tendon from one location to another to restore function and stability to the shoulder joint. It is usually done when the rotator cuff, a group of muscles and tendons that surround the shoulder joint, is torn and cannot be repaired.
What are Indications for Anterior and Posterior Tendon Transfers?
The rotator cuff helps to lift and rotate the arm and stabilize the shoulder joint. When it is torn, it can cause pain, weakness, reduced range of motion, and difficulty performing daily activities. Sometimes, the tear is too large or too old to be reattached to the bone using sutures or anchors. In that case, a tendon transfer may be an option
Types of Anterior and Posterior Tendon Transfer
There are different types of tendon transfers for rotator cuff repair, depending on the location and size of the tear.
- The latissimus dorsi transfer, which involves moving a tendon from the back muscle (latissimus dorsi) to the front or back of the upper shoulder area.
- The lower trapezius transfer, which involves moving a tendon from the lower trapezius muscle to the back of the shoulder.
- The pectoralis major transfer, which involves moving a tendon from the chest muscle to the front of the shoulder.
Preparation for Anterior and Posterior Tendon Transfer
Prior to the surgery, your surgeon will conduct a physical examination of the affected area and perform certain imaging tests before instructing you to:
- Stop taking any medications
- Fast after midnight on the day of surgery
- Arrange for a drive home after surgery
- Arrange for help with tasks at home
Anterior and Posterior Tendon Transfer Procedure
The procedure is usually done under general anesthesia and may take several hours. The surgeon makes an incision in the donor site where the tendon is taken from and another incision in the recipient site where the tendon is attached. The surgeon detaches one end of the donor tendon and passes it under or over other muscles and tendons to reach the recipient site. The surgeon then attaches the donor tendon to the remaining rotator cuff or bone using sutures or anchors.
Recovery after Tendon Transfer Procedure
The recovery time after a tendon transfer may vary depending on the type of transfer, the patient's condition, and the rehabilitation protocol. In general, patients may need to wear a sling or brace for several weeks to protect the shoulder and allow healing. Patients may also need to do physical therapy exercises to regain strength, mobility, and function of the shoulder.
Benefits of Anterior and Posterior Tendon Transfer
Some possible benefits of a tendon transfer for rotator cuff repair are:
- Reduced pain
- Improved function and stability of the shoulder joint
- Increased range of motion and strength of the arm
- Improved quality of life and ability to perform daily activities
Risks associated with Anterior and Posterior Tendon Transfer
Some possible risks or complications of a tendon transfer for rotator cuff repair are:
- Nerve damage
- Stiffness or loss of motion
- Weakness or loss of function
- Failure or detachment of the transferred tendon
- Need for revision surgery