Long head BIceps TEnodesis or tenotomy in arthroscopic rotator cuff repair: BITE study protocol

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder Arthroscopy

Background:

• The optimal management of the diseased long head of the biceps (LHB) tendon during rotator cuff repair is debated.
• Existing meta-analyses show no significant difference in strength or functional outcomes between tenotomy and tenodesis, but often lack high-quality evidence.
• There is a need for robust evidence to guide surgical decisions for LHB tendon pathology in conjunction with rotator cuff repair.

Purpose of the Study:

• To compare functional outcomes between LHB tenotomy and LHB tenodesis when performed as an adjunct to arthroscopic rotator cuff repair.
• To provide strong evidence to support clinical decision-making regarding LHB tendon management.
• To evaluate various clinical and patient-reported outcomes, including shoulder function, pain, and cosmetic appearance.

Main Methods:

• A randomized controlled trial involving patients over 50 years old with specific rotator cuff tears and LHB pathology.
• Patients were randomized to undergo either LHB tenotomy or LHB tenodesis.
• Outcomes including Constant score, Oxford Shoulder Test, DASH, "Popeye" deformity, elbow flexion strength, and pain were assessed pre-operatively and at 6 weeks, 3 months, and 1 year post-surgery.

Main Results:

• This section is not available in the provided abstract.
• Further analysis of collected data is required to determine the primary and secondary outcomes.
• The study is powered to detect non-inferiority between the two surgical techniques.

Conclusions:

• This study will contribute valuable evidence regarding the risks and benefits of LHB tenotomy versus tenodesis in patients undergoing rotator cuff repair.
• The findings will aid in managing patient expectations and optimizing surgical treatment strategies for combined LHB and rotator cuff pathology.
• Further research is needed to solidify best practices in managing the long head of the biceps tendon during rotator cuff surgery.