Tendon Transfers
Tendon Transfers in San Antonio, TX
Some shoulder problems cannot be fixed by simply sewing a tendon back down. A very large, long-standing rotator cuff tear or a muscle that no longer works may leave your shoulder weak and painful. If you are a candidate, moving a nearby tendon to take over the lost function may be an option.
Travis C. Burns, MD, a board-certified orthopedic surgeon in San Antonio, TX, evaluates complex shoulder problems at his Medical Center, Alamo Heights and Westover Hills offices. Dr. Burns specializes in arthroscopic and open shoulder procedures, including anatomic and reverse shoulder replacement, and he considers repair, transfer and replacement options in light of your age, activity and goals.
What Is Tendon Transfers?
A tendon transfer is surgery that moves a working tendon and its muscle to a new attachment point so it can do the job of a damaged tendon that cannot be repaired. In the shoulder, transfers may be used for certain irreparable rotator cuff tears, loss of shoulder rotation or tendon injuries that cannot be repaired. The transferred muscle is retrained with therapy to work in its new role.
Tendon transfers differ from standard repairs such as Rotator Cuff Repair or Pectoralis Major Repair, and from replacement options such as Reverse Shoulder Replacement. Another option for large tears is Superior Capsular Reconstruction.
What Are the Benefits of Tendon Transfers?
If you are an appropriate candidate, a transfer may offer potential benefits:
- Restored function: The transferred muscle may help you lift or rotate your arm.
- Pain relief: Rebalancing forces in the shoulder may reduce pain.
- Joint preservation: A transfer may let you keep your own joint.
- Alternative to replacement: For some patients, particularly younger ones, it may be considered before replacement.
- Targeted treatment: The choice of tendon depends on which function you have lost.
Your benefits vary, and recovering strength takes time and effort in therapy.
Who Needs Tendon Transfers?
You may be a candidate for a tendon transfer when other options are not likely to work. Situations may include:
- A large rotator cuff tear that cannot be repaired
- Weakness lifting or rotating your arm that limits daily life
- A tendon injury that has retracted or has poor tissue quality
- A failed prior rotator cuff repair
- An active lifestyle and a wish to avoid replacement
- A shoulder that still has good cartilage
Not every large tear requires a transfer. Some patients do well with therapy, injections or other procedures, and Dr. Burns can discuss which approach makes sense for your shoulder.
What Does Preparation for Tendon Transfers Involve?
Your evaluation includes a history, a strength and motion exam and imaging such as X-rays and MRI. Your surgeon reviews the condition of your rotator cuff and muscles, the health of your joint cartilage and your goals. Choosing the right transfer depends on what function you have lost.
You will receive instructions about medications and the day of surgery, as described in the Preoperative Instructions. Planning for a sling and for help at home may make your recovery easier.
How Is Tendon Transfers Performed?
The surgery may combine arthroscopic work inside the shoulder, as described on the Shoulder Arthroscopy page, with an incision to reach the tendon being moved. The donor tendon is freed, prepared and moved to its new attachment on the upper arm bone or another site.
The tendon is secured with sutures and anchors, and the tension and motion are checked before the incisions are closed. A sling or brace is then applied. Which tendon is moved and the exact technique depend on your shoulder and are discussed with you before surgery.
What to Expect During Recovery After Tendon Transfers?
The First Weeks
A sling or brace protects the transfer while it heals, and your arm is often kept in a protective position. Pain medication is typically provided, and gentle exercises of your hand, wrist and elbow are encouraged. See the Postoperative Instructions.
The Following Months
Therapy is a major part of your result, because the transferred muscle must learn a new job. Motion is restored first, then strengthening begins in stages. Recovery often takes many months, and gains may continue over time. See the Physical Therapy Protocols page.
Returning to Activity
Return to lifting, overhead work and sports varies by patient and by the type of transfer. Your surgeon and therapist will guide your progress.
What Are the Risks and Complications of Tendon Transfers?
As with any surgery, there are potential risks. Possible risks and complications include:
- Infection
- Stiffness or loss of motion
- Failure of the transfer to heal
- Persistent weakness or pain
- Nerve or blood vessel injury
- Loss of function at the donor site
- Need for additional surgery
- Complications related to anesthesia
Your surgeon can discuss these risks and how they apply to you based on your individual condition, health and activity goals.
Why Choose Dr. Burns for Tendon Transfers in San Antonio, TX?
Travis C. Burns, MD is a board-certified orthopedic surgeon with subspecialty fellowship training in orthopedic sports medicine through the John A. Feagin, Jr. Sports Medicine Fellowship. His practice centers on arthroscopic surgery of the shoulder, hip and knee, which covers a range of shoulder reconstruction options, from repair to replacement.
Dr. Burns previously served as Chief of Sports Medicine at San Antonio Military Medical Center, where his clinical focus was complex shoulder, hip and knee injuries. He has been active in research and academic medicine, including more than 35 peer-reviewed publications. You can meet with him at the Medical Center, Alamo Heights or Westover Hills office, depending on what is most convenient for you.
Tendon Transfers FAQs
What is a shoulder tendon transfer?
A shoulder tendon transfer is surgery that moves a healthy tendon to a new spot so its muscle can replace the function of a rotator cuff or other tendon that cannot be repaired.
Will the transferred muscle work normally?
Not exactly. The muscle can learn a new role, but your strength and motion may not match a healthy shoulder, and therapy is a key part of recovery.
Is a transfer the same as a tendon repair?
No. A repair sews the original tendon back to bone, while a transfer moves a different tendon to replace the function of one that cannot be repaired.
Who is a good candidate?
Usually someone with an irreparable tear or lost function but relatively healthy joint cartilage. Your surgeon will consider your age, goals and the condition of your shoulder.
How long is recovery?
Usually many months. Your timeline depends on the transfer and your progress in therapy.
What are the alternatives?
Alternatives may include therapy, injections, debridement, superior capsular reconstruction and, in some cases, shoulder replacement. Dr. Burns can review which fit your situation.
Tendon Transfers in San Antonio, TX
If a large tear or a weak shoulder is limiting your life, an evaluation can help you explore repair, transfer and replacement options. Request an appointment in San Antonio with Dr. Burns at the Medical Center, Alamo Heights or Westover Hills office to discuss your tendon transfer options. You can call (210) 705-5060 to schedule a visit.
