Indikation, Technik und Ergebnisse von Sehnentransferoperationen

Background: In the last few decades, tendon transfer procedures have become established for the treatment of younger patients with irreparable rotator cuff tears. Objectives: Indication, predictive factors and clinical results of tendon transfer procedures in rotator cuff surgery and modified surgical techniques are discussed. Methods: The current literature and expert opinions are discussed in association with our own case series. Results: In recent years a number of predictive factors, important to consider for surgical indication, have been analyzed for M. latissimus dorsi transfer (postero-superior defects) and M. pectoralis major transfer (anterior defects). Because the indication is restricted to the short time interval between reparable tear and apparent cuff arthropathy, the number of cases is limited. Clinical results in currently published case series show on average a significant functional improvement, but not complete restoration of shoulder function. Larger case series have been published for M. latissimus dorsi transfer and this technique presents superior clinical results compared to the results observed in patients after M. pectoralis major transfer. Conclusion: Tendon transfer techniques offer an additional therapeutic option during the time interval between still reparable rotator cuff tear and cuff arthropathy; however, clinical results are highly dependent on correct indication.