[Results of surgical treatment of proximal biceps tendon rupture]

During a 9-year period we operated on 19 patients in whom the proximal tendon of the biceps brachii muscle had been disruptured. Various surgical techniques were employed, such as refixation at the processus coracoideus, tenodesis in the sulcus intertubercularis, keyhole operation, in combination with an intraarticular inspection, revision, or if necessary widening of a narrow passage ("defile"). Follow-up was possible in 15 patients for an average period of 3 years after the operation, in respect of clinical, roentgenological and isokinetic findings. Results were mainly good while employing a variety of different surgical techniques; in only 3 patients the shoulder function remained restricted, painful and/or weakened. The isokinetic maximum torque was either increased on the operated side (after coracoid refixation) or reduced (after tenodesis in the sulcus). The underlying biomechanical causes are explained. Good results can be obtained in surgical treatment of the rupture of the proximal biceps tendon provided the procedure is accurately executed while taking into consideration, at the same operation stage, the associated pathology of the rotatory cuff. For biomechanical reasons, preference should be given to the operations according to Hitchcock and Bechtol in respect of refixation, and to the keyhole operation method.