Tendon transfer surgery for irreparable rotator cuff defects is described in the sparse literature, and long-term results are only described for the coverage of either posterior-superior or anterior-superior defects; here the reported results are good. This article reports on the long-term course of a patient who, coincidentally, was admitted to our hospital 10 years after a combined latissimus dorsi (LD) and pectoralis major (PD) transfer for a circumferential rotator cuff defect on the occasion of a knee arthroplasty. With regard to his shoulder operation 10 years ago, he was completely symptom-free and fully active in his profession as a farmer without any restrictions and showed excellent shoulder function. The current and previous imaging (magnetic resonance imaging [MRI], X-rays) were compared and, in line with the literature, showed increasing joint degeneration over time. As described in the literature for isolated tendon transfers, it appears to be possible to achieve very good shoulder function over the long-term despite radiological morphological and MRI evidence of increasing joint degeneration, even for combined LD and PM transfers.