Table 3.

Tendon transfer options for irreparable rotator cuff tears.

Rotator cuff deficiency	Tendon transfer	Outcomes	Considerations
Posterosuperior	Latissimus Dorsi	Gerber et al.(59) 10-year results show improvements in SSV, Constant score, ROM and strength but slight increase in osteoarthritic change	Intact subscapularis(59) Passive forward flexion and abduction >80°(60) No pseudoparalysis Increased risk of failure in Hamada III or IVa(61) Poor outcomes with Teres minor fatty infiltration Goutallier 3 or 4(62) Change in function of donor tendon from internal to external shoulder rotator
	Lower trapezius with achilles allograft	Elhassan et al.(63) Almost 4 year results show 97% patients with improvements in pain, SSV and ROM.	Anatomic line of pull(64)
	Teres major	Kolk et al.(65) Mean follow up at 10 years showed improvement in SSV, Constant score and pain
Anterosuperior	Pectoralis major	Ernstbrunner et al.(66) 20 year follow up showed significant improvements in Constant score and SSV. Active forward elevation improved but active internal and external rotation reduced from short term follow up. 19% incidence of osteoarthritis	Different line of pull of pectoralis major to subscapularis(67) Better outcomes with centred humeral head and intact supraspinatus(67)
	Latissimus Dorsi +/− Teres major	Elhassan et al.(68) Early results at mean 13 month follow up show significant improvement in pain, SSV, Constant score and ROM	Anatomic line of pull(69)