Editorial Commentary: Shoulder Biceps Tenotomy Versus Tenodesis Surgical Decision Making Must be Individualized for...

The optimal treatment for proximal biceps tendon lesions identified at the time of arthroscopic rotator cuff repair remains a topic for debate. The decision between biceps tenotomy and tenodesis is one in which we will likely never have a clear-cut answer. Proponents of biceps tenotomy and biceps tenodesis will cite the pros and cons of each surgical option to support their treatment of choice. Several meta-analyses have shown no superior outcomes with either treatment. Cost analysis and surgical efficiency may favor biceps tenotomy, whereas the possible development of a Popeye deformity, biceps cramping, and supination strength favor tenodesis. The surgical treatment of choice requires an informed discussion and shared decision making between surgeon and patient to determine patients' expectations and maximize surgical outcomes for each individual patient.