How the Biomechanical Complexity of Tendon Transfers in Shoulder Surgery is Still Robbing us of Sleep in 2021

The management of massive irreparable rotator cuff tears in the young and active patient population without severe osteoarthritis still presents a challenge for shoulder surgeons because of the limited number of treatment options available providing predictable outcomes.1,2 Large, retracted tears often result in devastating glenohumeral kinematics3,4 and decreased overall shoulder function, thus underlining the importance of restoring native-like biomechanics of the shoulder joint.5-7 However, complex and synergistic biomechanical interactions are required to provide a biomechanically stable system for ensuring ideal shoulder function during all movement sequences.