Does Concomitant Biceps Tenotomy Affect Shoulder Proprioception and Strength? A Prospective Intra‑Individual...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder Biomechanics

Background:

• Pathology of the long head of the biceps tendon (LHBT) often co-occurs with rotator cuff tears.
• The impact of concurrent LHBT tenotomy during arthroscopic rotator cuff repair (RCR) on postoperative shoulder proprioception and upper-limb strength is not well-established.
• Limited intra-individual evidence exists regarding these effects.

Purpose of the Study:

• To compare postoperative shoulder proprioception and upper-limb strength in patients undergoing arthroscopic rotator cuff repair (RCR) with and without concurrent long head of the biceps tendon (LHBT) tenotomy.
• To provide intra-individual evidence on the effects of LHBT tenotomy on shoulder function after RCR.

Main Methods:

• Prospective, intra-individual comparison at a single center (May 2018 - December 2021).
• Seventy-seven adult patients undergoing arthroscopic RCR with LHBT tenotomy were assessed postoperatively.
• Outcomes measured: shoulder joint-position sense (active position reproduction) and maximum isometric upper-limb strength (handheld dynamometer).

Main Results:

• Small side-to-side differences were observed in strength and proprioception.
• Absolute proprioception error at 30° rotation was modestly lower on the operated side (Δ=-2.00°).
• No clinically meaningful differences were found in other proprioception targets; effect sizes were small.

Conclusions:

• Concurrent LHBT tenotomy during arthroscopic RCR is not associated with measurable deficits in shoulder proprioception or upper-limb strength in patients with indications for tenotomy.
• These findings support the clinical acceptability of LHBT tenotomy when indicated.
• Further comparative studies are recommended to refine patient selection criteria.