Rotator cuff tear with concomitant long head of biceps tendon (LHBT) degeneration: what is the preferred choice? Open subpectoral versus arthroscopic intraarticular tenodesis

• Main Authors: Mohsen Mardani-Kivi, Sohrab Keyhani, Mohammad-Hossein Ebrahim-Zadeh, Keyvan Hashemi-Motlagh, Khashayar Saheb-Ekhtiari
• Format: Article
• Language: English
• Published: SpringerOpen 2019-07-01
• Series: Journal of Orthopaedics and Traumatology
• Subjects: Rotator cuff tear; Open subpectoral tenodesis; Arthroscopic intraarticular tenodesis; Long head of biceps tendon; Shoulder function; Pain intensity
• Online Access: http://link.springer.com/article/10.1186/s10195-019-0531-5
• ISSN: 1590-9921; 1590-9999

Abstract Background Lesions associated with the biceps tendon are commonly detected during arthroscopic repair of rotator cuff tears. Acquiring a preferable technique to repair both cuff and long head of biceps tendon (LHBT) lesions was the aim of several recent studies. This study aimed to compare clinical and functional outcomes of open subpectoral versus arthroscopic intraarticular tenodesis in patients with repairable rotator cuff tear associated with LHBT degeneration. Patients and methods In this randomized clinical trial, 60 eligible candidates for arthroscopic rotator cuff repair (mean age 55.7 ± 6.9 years) were allocated to a control group (open subpectoral, SP) or intervention group (intraarticular, IA). In the IA group, an anchor suture was used for both rotator cuff repair and LHBT tenodesis. In the SP group, after arthroscopic repair of the rotator cuff, subpectoral tenodesis of LHBT was performed using an interference screw. Patients were evaluated for 2 years follow-up regarding pain intensity using the visual analogue scale (VAS) and shoulder function using the Constant Score and Simple Shoulder Test. Results The two groups were similar with regard to demographic characteristics and preoperative evaluations (all P > 0.05). The functional status of both groups was improved, but not significantly differently so between the two groups (P = 0.1 and P = 0.4, respectively). Pain intensity decreased during the 2-year follow-up period, similarly so in the two groups. Patient satisfaction was also similar in the two groups. Conclusion Large and massive rotator cuff tears (tears > 3 cm) associated with LHBT pathologies benefited from intraarticular or subpectoral tenodesis similarly, with no differences in short- or mid-term results between these two techniques. Level of evidence II.