Despite considerable innovations in surgical techniques, irreparable rotator cuff tears still represent a challenge for shoulder surgeons. Several treatment options are available, but the literature lacks consensus on the gold standard for young active patients without glenohumeral arthritis in which replacement surgery cannot be considered.¹ Tendon transfers come as a reliable treatment to restore coronal force couples in shoulder kinematics and provide range of motion (ROM) improvement.²

Three techniques of the latissimus dorsi (LD) transfer have been described in the literature. Gerber et al. first described a full open technique to treat irreparable rotator cuff tears.³ The hypothesis was that the transferred tendon could improve and prevent the humeral head from proximal migration. In a recent paper, Cutbush et al proposed a full arthroscopic technique for harvesting, mobilization, and fixation of the LD tendon.⁴ In the present chapter, the authors present their preferred technique: an arthroscopically assisted latissimus tendon transfer that combines the advantages of both open and arthroscopic fashion. The first part is dedicated to tendon harvesting through a mini-invasive axillary approach followed by an arthroscopic fixation.⁵