The Effect of Biceps Procedure on the Outcome of Rotator Cuff Reconstruction

Abstract

Purpose. Biceps long head pathology is often associated with rotator cuff tears. The aim of this study was to determine the effect of possible associated biceps procedure on the treatment outcome in rotator cuff repair. Methods. 148 consecutive shoulders operated for isolated full-thickness supraspinatus tendon tear were included. A biceps tenotomy or tenodesis was performed in cases of irritated/frayed and/or unstable biceps tendon. The patients were grouped into three groups according to the biceps procedure (no procedure, tenotomy, and tenodesis). The age-adjusted Constant score was used as an outcome measure. Results. 145 shoulders (98%) were available for final followup. Preoperatively, there was no statistically significant difference in Constant scores. At three months, there was a statistically significant positive change in Constant scores compared with preoperative status in the tenotomy group in women. At one year there was a statistically significant positive change in Constant scores in all groups in both genders. However, there was no statistically significant difference between the groups at one year in either gender. Conclusion. Biceps procedure does not affect the final clinical treatment outcome after rotator cuff repair. Recovery from operative treatment may be faster in tenotomized female patients in cases of encountered biceps pathology.

Demographic trends in arthroscopic and open biceps tenodesis across the United States

“…Both arthroscopic and open biceps tenodesis were performed more commonly in association with disease of the RTC than the biceps tendon despite recent literature to suggest it may or may not improve outcomes in this population. 18,19 Future studies are needed to compare the clinical efficacy of open vs. arthroscopic tenodesis and their effectiveness in comparison to simple tenotomy.…”

“…6,7,31,33 In a number of recent studies, the addition of biceps tenodesis in the setting of RTC repair had equivocal effect on the subjective outcomes when performed and in comparison to tenotomy. 18,20 Therefore, the forces driving the increased utilization of tenodesis are uncertain. Furthermore, the increased use of arthroscopic tenodesis in the absence of data suggesting it is more effective, faster, or less expensive should be noted.…”

No difference between tenotomy vs tenodesis for the long head of the biceps tendinopathy in rotator cuff repair: a systematic review

“…The overall number of procedures amounted to 1518, with 1502 patients involved. The average follow-up was 30.3 months, ranging from 12.0 16 to 57.0 months 4 Table 1. summarises the relevant study details.…”

“…The Constant score improved significantly after surgery (p<0.0001), whereas no statistical difference was found between the two groups (p=0.77). Kukkonen et al 16 evaluated a cohort of 145 consecutive shoulders for repaired supraspinatus tendon tear. The cohort was then divided in three groups: no biceps procedure (85 patients), tenotomy (30 patients) and tenodesis (30 patients).…”

“…Koh et al 15 reported that in the tenodesis group, four (9.3%) patients developed Popeye deformity versus 11 patients (26.8%) in the tenotomy group (p=0.036). Kukkonen et al 16 reported complication of groups where LHB pathology was addressed. A Popeye deformity was observed in eight patients (31%) in the tenotomy group and in three (13%) in the tenodesis group.…”