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Updated: Feb 20, 2026

Knotless Independent Double-Row Repair and Biceps Augmentation for Anterosuperior Rotator Cuff Tears
Published on: January 23, 2026
Popeye sign: Tenodesis vs. self-locking "T" tenotomy of the long head of the biceps
X Clement1, F Baldairon1, P Clavert1
1Centre de Chirurgie Orthopédique et de la Main, 10, Avenue Achille-Baumann, 67400 Illkirch-Graffenstaden, France.
Introduction:
Treatment of long head of the biceps lesions is controversial. A new technique of self-locking "T" tenotomy was developed in our department in 2013.
Hypothesis:
The main objective of the present study was to assess onset of Popeye sign after "T" tenotomy, with comparison to long head of the biceps tenodesis.
Material And Methods:
A continuous retrospective study included 180 patients with long head of the biceps lesion, either isolated or associated with rotator cuff tear.
Results:
130 underwent "T" tenotomy (group A), and 50 tenodesis (group B). Mean age was 57.9 years (range, 23-88 years) in group A and 50.8 years (range, 20-66 years) in group B. At last follow-up, 27.7% of patients in group A and 24% in group B showed Popeye sign (P=0.616), after equivalence test and adjustment on age and occupational activity. Bicipital groove pain was more frequent in the tenodesis group (44% versus 25.4%; P=0.025).
Discussion:
Self-locking "T" tenotomy did not significantly differ from tenodesis in onset of Popeye sign or clinical results, and showed better postoperative course.
Level Of Evidence:
IV, retrospective study.

