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Tenderness on the bicipital groove: is it an indication for biceps procedure during rotator cuff repair?-A
Seong-Jun Kim1, Jae-Hyung Lee2, Kyung-Soo Oh3
1Joint Center Department of Orthopedic Surgery, Seoul Bumin Hospital, Seoul, Republic of Korea.
Background:
Treating long head of biceps lesions associated with rotator cuff tears is a major issue, and pain alone without any other structural lesion may be an indication for treating biceps. The purpose of this study was to evaluate the advantages of tenodesis in patient with symptom of pain on the bicipital groove without biceps lesions during rotator cuff repair.
Method:
This study included 90 patients [38 males, 52 females; average age, 59.19 (range, 42-74) years] who underwent surgery for rotator cuff tears (small- to medium-sized) between February 2020 and August 2021. All patients had pain on the bicipital groove and no biceps tendinopathy (complete tear, partial tear, severe tenosynovitis, superior labrum anterior and posterior lesion (II, III, IV), and subluxation). Patients were randomly assigned to either the tenodesis group or the no-specific treatment group based on the parity of their enrollment number. Patients with odd-numbered enrollment were allocated to the tenodesis group (T) (n = 45), while those with even-numbered enrollment were assigned to the no-treatment group (N) (n = 45). The mean follow-up duration was 28.53 (range, 24-44) months. Preoperative and postoperative (24 months) visual analog scale (VAS) scores and American Shoulder and Elbow Surgeons (ASES) scores were calculated. Also, pain on bicipital groove, effusion, injection on the bicipital groove, and presence of Popeye deformity was checked.
Results:
Both groups demonstrated significant improvements in VAS and ASES scores at 24 months. However, the between-group differences did not exceed the minimal clinically important difference (VAS difference = 0.58, ASES difference = 1.13; both P > .05). Persistent bicipital groove pain was significantly more frequent in the N group (24.4%) compared to the T group (2.2%, P < .01). The N group also had a higher incidence of postoperative corticosteroid injection (17.8% vs. 2.2%, P < .03). No Popeye deformities were observed in either group.
Conclusion:
Although pain, VAS score, and ASES score were improved in both groups, treating bicipital groove pain with tenodesis during rotator cuff repairs in patients with pain on the bicipital groove is effective on reducing pain and injection after operation.
