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Irreparable rotator cuff defects and muscle transfers

Understanding the rotator cuff: function and common injuries

The rotator cuff consists of four muscles and their associated tendons that stabilize the shoulder joint and enable a variety of movements. These include

  • Supraspinatus
  • Infraspinatus
  • Teres minor
  • Subscapularis

Damage to the rotator cuff can be caused by acute injuries, repeated overhead activities or age-related degeneration.

Cartilage and bone transplants in the shoulder

Common causes of rotator cuff injuries

  • Trauma - falls, accidents or sudden heavy loads can lead to tears.
  • Repetitive strain injuries - athletes and people who work overhead are particularly at risk.
  • Degeneration - Natural wear and tear weakens the tendons over time.
Are you suffering from irreparable rotator cuff defects and muscle transfers and looking for a specialist?
Contact me

When is a rotator cuff defect considered irreparable?

A rotator cuff tear is classified as irreparable if:

  • The tear is too large and there is considerable tendon retraction.
  • muscle atrophy and fatty infiltration make successful suturing unlikely.
  • Previous surgical repairs have failed and there is permanent dysfunction.

In such cases, alternative treatment approaches must be considered.

Muscle transfers as a solution for irreparable rotator cuff tears

Muscle transfers can restore shoulder function by redirecting muscles to compensate for the loss of rotator cuff function.

Available muscle transfer techniques

The most common muscle transfers are

  • Latissimus dorsi transfer - Often used for posterosuperior rotator cuff defects and improves external rotation and stability.
  • Pectoralis major transfer - Suitable for anterosuperior defects, helps restore forward elevation and internal rotation.

Surgical procedure and techniques

  • Preoperative assessment - An MRI analysis and clinical examinations determine the extent of the damage and the suitability for a muscle transfer.
  • Surgical procedure - The selected muscle is released from its original attachment point, mobilized and reattached to the humeral head.
  • Fixation and rehabilitation - The muscle is fixed in a stable position and a targeted rehabilitation program begins to restore function.

Advantages of muscle transfers compared to other treatments

  • Preservation of joint integrity - In contrast to shoulder joint replacement, the natural joint is preserved.
  • Improved shoulder function - Increases strength, stability and mobility.
  • Better option for younger patients - Allows active individuals to maintain better function compared to a joint replacement.

Who can benefit from this process?

Muscle transfer is recommended for:

  • Patients with chronic, irreparable rotator cuff tears
  • People with failed rotator cuff reconstructions
  • Patients with persistent pain and functional limitations despite conservative treatment
Are you suffering from irreparable rotator cuff defects and muscle transfers and looking for a specialist?
Contact me

Success rates and case studies

Clinical studies show that muscle transfers can significantly improve shoulder function and reduce pain. Success depends on factors such as age, muscle quality and post-operative rehabilitation. Most patients report better mobility and less discomfort within six months of surgery.

Frequently asked questions

Full recovery usually takes 3 to 6 months, with gradual improvement in strength and mobility. A structured rehabilitation program is crucial for an optimal result.

Many patients achieve almost normal shoulder function. Even if a complete recovery is not always possible, most experience a significant reduction in pain and improved mobility.

As with any operation, there are risks such as infection or incomplete healing, but these complications rarely occur thanks to modern surgical techniques and careful aftercare.

Muscle transfers are preferred for active people under the age of 70. However, suitability depends on the muscle quality and general health of the patient.

In contrast to the inverse shoulder prosthesis, the natural shoulder joint is retained, which is advantageous for patients with functional deltoid muscles.

Contact for further information

If you suffer from shoulder pain and would like to find out about treatment options, please contact me for a consultation.

The following languages are spoken in my ordination:

German, English, French, Russian, Slovak, Czech

My ordination in 1190 Vienna
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