What is a Tendon Transfer?
The shoulder joint is made up of a complex group of structures, including bones, muscles, ligaments, tendons, and nerves, that support movement in multiple directions. People with shoulder injuries or disorders may experience symptoms including pain, numbness and tingling, weakness, or difficulty raising and moving the arm normally.
Tendons, the strong connective tissue that attaches muscle to bone, can be injured due to trauma or overuse. Tendon transfers in the shoulder are a treatment option in two scenarios: when a patient has an injury to the tendons that cannot be repaired, or when there is paralysis in a chest or shoulder muscle. These procedures are done with arthroscopic assistance and are usually recommended only after other non-surgical treatments, including physical therapy and injectable medications, do not provide symptom relief.
During tendon transfer surgery, the orthopedic surgeon replaces the damaged tendon with a healthy tendon taken from another area in the shoulder or shoulder blade. After recovery, the transferred tendon takes over the job of the tendon that has been replaced.
Who is a Candidate for Tendon Transfer?
The most common diagnosis in patients undergoing tendon transfer is a history of irreparable or chronic rotator cuff tears, or failed rotator cuff repairs with reinjury to the tendon(s). Typically, patients are between 30 and 65 years old with active jobs that involve repetitive overhead motion. Professional and recreational athletes are also at risk for degenerative rotator cuff tears.
In order to undergo tendon transfer, patients must be free of arthritis in the shoulder joint. Physical examination, medical history and the results of any imaging or neuromuscular tests are also used to ensure that tendon transfer is the best option. Older patients are more likely to be suitable for a shoulder replacement.
Recovery
After a shoulder tendon transfer, patients must wear a sling or brace for 6-8 weeks to allow for optimal healing. Patients then undergo a comprehensive physical therapy program to regain strength and range of motion. The average recovery time usually takes 4-6 months, and patients can make additional progress for up to one year after surgery. In many cases, tendon transfer surgery provides good pain relief and restores strength and range of motion.
A small percentage of patients may require revision surgery or, eventually, a shoulder replacement.