Rotator Cuff Tendon Transfer
A surgical procedure to restore shoulder function by transferring a healthy tendon
Rotator cuff tendon transfer involves moving a healthy tendon from a different part of the body to restore shoulder stability and function when the existing rotator cuff tendons cannot be repaired.
Common Reasons for Surgery
- Irreparable rotator cuff tears.
- Persistent pain and weakness in the shoulder despite non-surgical treatments.
- Loss of overhead mobility and strength.
- Shoulder instability affecting daily activities.
Goals of the Procedure:
- Restore shoulder stability and movement.
- Reduce or alleviate pain.
- Improve the ability to perform everyday tasks and physical activities.
Preparation for Surgery
Preparation for tendon transfer surgery is essential for optimising outcomes and ensuring a smoother recovery process.
Steps in Preparation:
- Consultation and Imaging: Dr Ben McGrath will assess your condition using imaging techniques like X-rays, MRIs, or CT scans to evaluate the damage and plan the procedure.
- Health Optimisation: Patients may be advised to engage in prehabilitation exercises, maintain a healthy weight, and stop smoking to support healing.
- Fasting Instructions: Fasting before surgery is usually required, and Dr McGrath will provide specific guidance on this.
- Medication Review: Certain medications, such as blood thinners, may need to be adjusted or paused before the procedure.
What Happens During the Surgery?
Tendon transfer surgery is typically performed as a minimally invasive procedure, promoting quicker recovery.
Surgical Steps:
- Anaesthesia: General anaesthesia is administered to ensure patient comfort.
- Accessing the Shoulder: Small incisions are made for the insertion of arthroscopic instruments.
- Tendon Transfer: A healthy tendon, such as the latissimus dorsi or pectoralis major, is detached and repositioned to replace the damaged rotator cuff tendon.
- Securing the Tendon: The transferred tendon is securely attached to the shoulder bone using sutures or anchors.
- Closure: Incisions are closed, and a sterile dressing is applied.
The surgery typically lasts 2 to 3 hours, depending on the complexity of the transfer.
Understanding the Risks
Like all surgeries, tendon transfer surgery carries potential risks.
Common Risks:
- Temporary stiffness or discomfort in the shoulder.
- Minor swelling or bruising at the surgical site.
Rare but Serious Risks:
- Nerve or blood vessel injury.
- Failure of the tendon to integrate properly.
Dr McGrath takes every precaution to minimise these risks and will discuss them with you before the surgery.
What to Expect After Surgery
Immediate Post-Operative Care:
- Pain management with medications and cold therapy.
- Use of a sling to immobilise and protect the shoulder.
- Instructions on wound care and restricted activities.
Discharge Instructions:
- Specific guidelines for showering, dressing changes, and resuming medications.
- Information about follow-up appointments to monitor recovery progress.
Rehabilitation and Recovery
Recovery from tendon transfer surgery involves a structured rehabilitation program to regain strength and mobility.
Phase 1: Early Recovery (Weeks 0–6):
- Focus: Protecting the tendon transfer and managing pain.
- Activities: Passive range-of-motion exercises guided by a physiotherapist.
Phase 2: Intermediate Recovery (Weeks 6–12):
- Focus: Regaining range of motion and light strengthening.
- Activities: Gradual introduction of assisted and active movements.
Phase 3: Advanced Recovery (Months 3–6):
- Focus: Strengthening and functional restoration.
- Activities: Progressive resistance exercises and resumption of daily activities.
Long-Term Outcomes
Rotator cuff tendon transfer aims to provide long-term pain relief and functional improvement.
Expected Improvements:
- Enhanced shoulder stability and strength.
- Reduced or eliminated shoulder pain.
- Improved ability to perform overhead and lifting activities.
Maintenance of Results:
- Adherence to physiotherapy and rehabilitation protocols.
- Avoiding excessive strain on the shoulder during recovery.
- Attending follow-up appointments for ongoing assessment.