The rotator cuff is a group of muscles and tendons that hold the shoulder joint in place and allow you to move your arm and shoulder. Problems occur when part of the rotator cuff becomes irritated or damaged. This can result in pain, weakness and reduced range of motion.

Sometimes one or more tendons become detached from the bone. In some cases, a surgeon can reattach the tendon to the bone using a thread-like material called a suture.

But sometimes the tendon is too badly damaged to be reattached. In that case, the surgeon may consider a "tendon transfer." This is a procedure in which a tendon from a different location is used to repair the rotator cuff.

The tendon most commonly transferred is the latissimus dorsi tendon in the back. For a latissimus dorsi transfer, the surgeon makes two incisions: one in the back and one in the front of the shoulder.

In the back, the surgeon detaches one end of a latissimus dorsi tendon and attaches a suture to that end. In the front, the surgeon creates a flap in the deltoid muscle, which covers the shoulder. He or she inserts a tool to grasp the end of the latissimus dorsi tendon. The surgeon brings the tendon under the deltoid to its new position.

Sutures are used to connect the transferred tendon to any remaining rotator cuff as well as bone. The surgeon tightens the sutures to pull the tendon against the bone and ties it securely in place. In some cases, anchors are inserted into the bone to help hold the sutures in place.

The surgeon closes the flap in the deltoid muscle. The incisions are then closed in the front and back.