Concomitant biceps intervention does not affect the outcome in the treatment of partial-thickness rotator cuff tear

Although procedures for long head of biceps (LHB), including LHB tenotomy and tenodesis, are commonly performed for patients with rotator cuff tear (RCT), the data about concomitant biceps procedures in the treatment of partial-thickness (PT) RCT has been limited.

Retrospective data were provided by the institutional Pan Am Clinic Orthopedic Surgery registry. The single surgical center collects surgeon- and patient-reported data for all arthroscopic surgeries as standard of care. Patients who underwent shoulder surgery for PT-RCT between April 2019 and August 2022 were included in this study. All patients were eligible for 1-year follow-up. Demographic, operative, and patient-reported outcomes were compared for patients treated with and without concomitant LHB intervention. Subanalyses compared patients treated with biceps tenotomy and biceps tenodesis. Operative data included LHB and RCT condition at the time of surgery, and outcomes included revision status, complications and the patient-reported outcomes American Shoulder and Elbow Surgeons and Single Assessment Numeric Evaluation score. Continuous variables were compared using a two-sided independent t-test, and categorical variables were compared using a chi-squared or Fisher's exact test.

The rate of LHB pathology including inflammation, partial tear, or rupture associated with PT-RCT was 58% (n = 66/113). Fifty-six percent (n = 63/113) of the patients treated for partial supraspinatus tendon tear underwent concomitant LHB intervention (Group I), and 44% (n = 50/113) did not undergo LHB intervention (Group N). The mean age of study patients was 54 years (standard deviation = 12), and 37% were female (male n = 71; female n = 42). Within Group I, 48% (n = 30/63) underwent tenotomy and 52% (n = 33/63) underwent tenodesis. LHB condition at the time of surgery was different between Group N and Group I (Fisher's exact P < .001) and between the tenotomy and tenodesis groups (Fisher's exact P < .001). No other significant differences were found in operative variables or patient-reported variables preoperatively or at the 1-year follow-up.

Concomitant biceps intervention does not affect the clinical outcome in arthroscopic shoulder surgery for PT-RCT. There was no significant difference in clinical outcomes between LHB tenodesis and tenotomy in the treatment of arthroscopic PT-RCT when LHB intervention was performed.