Abstract
Isolated ruptures of the subscapularis or combined with a supraspinatus tear are not as numerous as posterosuperior rotator cuff tears. Reconstruction of the anterosuperior tendons may not always be possible because of fatty infiltration or poor tendon quality. Tendon transfer may represent a surgical option for treatment. The pectoralis major tendon transfer is not the best biomechanical one to supply the deficient subscapularis, but it can be an acceptable salvage option to decrease pain even beyond a 10-year postoperative period but with limited function.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Tashjian RZ. Epidemiology, natural history, and indications for treatment of rotator cuff tears. Clin Sports Med. 2012;31:589–604.
Gerber C, Krushell RJ. Isolated rupture of the tendon of the subscapularis muscle. Clinical features in 16 cases. J Bone Joint Surg Br. 1991;73:389–94.
Gerber C, Hersche O, Farron A. Isolated rupture of the subscapularis tendon. J Bone Joint Surg Am. 1996;78:1015–23.
Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC. Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop. 1994;304:78–83.
Bokor DJ, Hawkins RJ, Huckell GH, Angelo RL, Schickendantz MS. Results of nonoperative management of full-thickness tears of the rotator cuff. Clin Orthop. 1993;294:103–10.
Levy O, Mullett H, Roberts S, Copeland S. The role of anterior deltoid reeducation in patients with massive irreparable degenerative rotator cuff tears. J Shoulder Elb Surg. 2008;17:863–70.
Hansen ML, Otis JC, Johnson JS, Cordasco FA, Craig EV, Warren RF. Biomechanics of massive rotator cuff tears: implications for treatment. J Bone Joint Surg Am. 2008;90:316–25.
Boileau P, Baqué F, Valerio L, Ahrens P, Chuinard C, Trojani C. Isolated arthroscopic biceps tenotomy or tenodesis improves symptoms in patients with massive irreparable rotator cuff tears. J Bone Joint Surg Am. 2007;89:747–57.
Walch G, Edwards TB, Boulahia A, Nové-Josserand L, Neyton L, Szabo I. Arthroscopic tenotomy of the long head of the biceps in the treatment of rotator cuff tears: clinical and radiographic results of 307 cases. J Shoulder Elb Surg. 2005;14:238–46.
Burkhart SS, Athanasiou KA, Wirth MA. Margin convergence: a method of reducing strain in massive rotator cuff tears. Arthroscopy. 1996;12:335–8.
Gartsman GM. Massive, irreparable tears of the rotator cuff. Results of operative debridement and subacromial decompression. J Bone Joint Surg Am. 1997;79:715–21.
Kim S-J, Lee I-S, Kim S-H, Lee W-Y, Chun Y-M. Arthroscopic partial repair of irreparable large to massive rotator cuff tears. Arthroscopy. 2012;28:761–8.
Iagulli ND, Field LD, Hobgood ER, Ramsey JR, Savoie FH. Comparison of partial versus complete arthroscopic repair of massive rotator cuff tears. Am J Sports Med. 2012;40:1022–6.
Berth A, Neumann W, Awiszus F, Pap G. Massive rotator cuff tears: functional outcome after debridement or arthroscopic partial repair. J Orthop Traumatol. 2010;11:13–20.
Gerber C. Latissimus dorsi transfer for the treatment of irreparable tears of the rotator cuff. Clin Orthop. 1992;(275):152–60.
Warner JJ. Management of massive irreparable rotator cuff tears: the role of tendon transfer. Instr Course Lect. 2001;50:63–71.
Mihata T, Lee TQ, Watanabe C, Fukunishi K, Ohue M, Tsujimura T, et al. Clinical results of arthroscopic superior capsule reconstruction for irreparable rotator cuff tears. Arthroscopy. 2013;29:459–70.
Mihata T, Watanabe C, Fukunishi K, Ohue M, Tsujimura T, Kinoshita M. Arthroscopic superior capsular reconstruction restores shoulder stability and function in patients with irreparable rotator cuff tears: a prospective study (SS-15). Arthroscopy. 2011;27:e36–7.
Mulieri P, Dunning P, Klein S, Pupello D, Frankle M. Reverse shoulder arthroplasty for the treatment of irreparable rotator cuff tear without glenohumeral arthritis. J Bone Joint Surg Am. 2010;92:2544–56.
Wirth MA, Rockwood CA Jr. Operative treatment of irreparable rupture of the subscapularis. J Bone Joint Surg Am. 1997;79:722–31.
Resch H, Povacz P, Ritter E, Matschi W. Transfer of the pectoralis major muscle for the treatment of irreparable rupture of the subscapularis tendon. J Bone Joint Surg Am. 2000;82:372–82.
Galatz LM, Connor PM, Calfee RP, Hsu JC, Yamaguchi K. Pectoralis major transfer for anterior-superior subluxation massive rotator cuff insufficiency. J Shoulder Elb Surg. 2003;12:1–5.
Jost B, Puskas GJ, Lustenberger A, Gerber C. Outcome of pectoralis major transfer for the treatment of irreparable subscapularis tears. J Bone Joint Surg Am. 2003;85:1944–51.
Klepps SJ, Goldfarb C, Flatow E, Galatz LM, Yamaguchi K. Anatomic evaluation of the subcoracoid pectoralis major transfer in human cadavers. J Shoulder Elb Surg. 2001;10:453–9.
Aldridge JM III, Atkinson TS, Mallon WJ, Durham B. Combined pectoralis major and latissimus dorsi tendon transfer for massive rotator cuff deficiency. J Shoulder Elb Surg. 2004;13:621–9.
Chaffai MA, Mansat M. Anatomic bases for the reconstruction of a musculotendinous flap derived from the pectoralis major muscle. Surg Radiol Anat. 1988;10:273–82.
Jennings GJ, Keereweer S, Buijze GA, De Beer J, DuToit D. Transfer of segmentally split pectoralis major for the treatment of irreparable rupture of the subscapularis tendon. J Shoulder Elb Surg. 2007;16:837–42.
Owens BD, Nelson BJ, Taylor DC. Acute brachial plexus compression after pectoralis major transfer for subscapularis insufficiency. Am J Sports Med. 2008;36:173–5. Epub 2007 Jul 19
Klepps SJ, Galatz LM. The treatment of anterior-superior instability with the pectoralis major muscle transfer. Oper Tech Orthop. 2003;13:228–34.
Valenti P, Boughebri O, Moraiti C, Dib C, Maqdes A, Amouyel T, Kany J. Transfer of the clavicular or sternocostal portion of the pectoralis major muscle for irreparable tears of the subscapularis. Technique and clinical results. Int Orthop. 2015;39:477–83.
Collin P, Matsumura N, Lädermann A, Denard PJ, Walch G. Relationship between massive chronic rotator cuff tear pattern and loss of active shoulder range of motion. J Shoulder Elb Surg. 2014;23:1195–202.
Costouros JG, Espinosa N, Schmid MR, Gerber C. Teres minor integrity predicts outcome of latissimus dorsi tendon transfer for irreparable rotator cuff tears. J Shoulder Elb Surg. 2007;16:727–34. Epub 2007 Nov 5
Elhassan B, Ozbaydar M, Massimini D, Diller D, Higgins L, Warner JJ. Transfer of pectoralis major for the treatment of irreparable tears of subscapularis: does it work? J Bone Joint Surg Br. 2008;90:1059–65.
Gerber A, Clavert P, Millet PJ, Holovacs TF, Warner JJP. Split pectoralis major and teres major tendon transfers for reconstruction of irreparable tears of the subscapularis. Tech Shoulder Elb Surg. 2004;5:5–12.
Konrad GG, Sudkamp NP, Kreuz PC, Jolly JT, McMahon PJ, Debski RE. Pectoralis major tendon transfers above or underneath the conjoint tendon in subscapularis-deficient shoulders. An in vitro biomechanical analysis. J Bone Joint Surg Am. 2007;89:2477–84.
Vidil A, Augereau B. Transfer of the clavicular portion of the pectoralis major muscle in the treatment of irreparable tears of the subscapularis muscle. Rev Chir Orthop. 2000;86:835–43.
Kany J, Guinand R, Croutzet P, Valenti P, Werthel JD, Grimberg J. Arthroscopic-assisted latissimus dorsi transfer for subscapularis deficiency. Eur J Orthop Surg Traumatol. 2016;26:329–34.
Elhassan B, Christensen TJ, Wagner ER. Feasibility of latissimus and teres major transfer to reconstruct irreparable subscapularis tendon tear: an anatomic study. J Shoulder Elb Surg. 2014;23:492–9.
Moroder P, Schulz E, Mitterer M, Plachel F, Resch H, Lederer S. Long-term outcome after pectoralis major transfer for irreparable anterosuperior rotator cuff tears. J Bone Joint Surg Am. 2017;99:239–45. https://doi.org/10.2106/JBJS.16.00485.
Mun SW, Kim JY, Yi SH, Baek CH. Latissimus dorsi transfer for irreparable subscapularis tendon tears. J Shoulder Elb Surg. 2018;27:1057–64. Epub 2018 Feb 3
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 ESSKA
About this chapter
Cite this chapter
Kany, J. (2020). Tendon Transfer for Anterosuperior Cuff: The Pectoralis Major Transfer. In: Sampaio Gomes, N., Kovačič, L., Martetschläger, F., Milano, G. (eds) Massive and Irreparable Rotator Cuff Tears. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-61162-3_26
Download citation
DOI: https://doi.org/10.1007/978-3-662-61162-3_26
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-662-61161-6
Online ISBN: 978-3-662-61162-3
eBook Packages: MedicineMedicine (R0)