Introduction
Having a Tendon transfer can be scary and frightening, especially if it is for your child. Going into this process with little to no knowledge of what is involved can make things even more scary.
Tendon transfers are when one tendon is put into a new position inside the body. This process is typically done to bring a tendon closer to the Joint needed due to a shortened or overstretched ligament. There are two types of tendon transfers: anterior and posterior. Let’s talk more about the steps involved in these procedures and what you can expect.
Anterior transfer
The anterior transfer is when one tendon is moved inferiorly to be in a position that the intended Joint can use. The posterior transfer is when one tendon is moved superiorly to bring it closer to the Joint needed.
Posterior
Posterior distal biceps transfer is a procedure in which the long head of the biceps tendon is transposed posteriorly to replace the function of a torn rotator cuff or labrum. The long head of the biceps tendon is transferred to the posterior aspect of the humeral head. It is used to treat a partial-thickness rotator cuff tear or to enhance function after surgery for a full-thickness rotator cuff tear.
The Tendon Transfer Process
Direct Fixation
Steps one and two stabilize the scapula and give the surgeon a stable platform for performing the tendon transfer. The first step is to create an arthroscopic portal.
It is done by making two small incisions, one in the shoulder and one in the biceps coracoid process. The surgeon will then use sharp hooks and forceps to create an opening.
Lag-Screw Fixation
The second step is to perform the muscle bypass. It involves the surgeon placing a string through the hole created in the muscle and attaching it to the removed muscles. Holding the shoulder down with one hand, doctors insert the titanium hooks through the incisions in the humerus’s coracoid process, shoulder blade, and acromion process.
Last step
The last way is a combination of direct fixation and lag-screw fixation. It involves the surgeon performing the direct fixation and then drilling holes into the bones and putting screws into them to keep them in place.
Recovery Process
The recovery process for this type of surgery is similar to that of most other surgeries. Patients will be required to use crutches after surgery and exercise prescribed by a physical therapist. The doctor may also prescribe pain medication.
Conclusion
A posterior distal biceps transfer is the procedure used when a patient needs their rotator cuff or labrum repaired or replaced due to injury. A surgeon will fixate the long head of the biceps tendon onto the posterior aspect of the humeral head to replace the function of a torn rotator cuff or labrum. When surgery is successful, all strength and range-of-motion should be restored, although only a tiny percentage of patients can return to sports.
