Tenodesis of the Long Head of the Biceps Tendon Has No Detrimental Impact on the Postoperative Outcome After Supraspinatus Tendon Reconstruction.

Introduction While several studies have compared tenotomy and tenodesis, few studies have examined whether performing a tenodesis of the long head of the biceps (LHB), when indicated, in patients who have undergone rotator cuff reconstruction has a detrimental impact on clinical and radiological postoperative outcomes. The present study aimed to investigate whether performing a tenodesis of the LHB has a damaging effect on the clinical and radiological outcome after rotator cuff reconstruction. Material and methods Fifty-one patients surgically treated for supraspinatus (SSP) tendon tears were included. All included patients received a reconstruction of the SSP, depending on the LHB surgery performed, patients were divided into two groups: 1) with concomitant tenodesis of the LHB and 2) without surgery of the LHB. Western Ontario Rotator Cuff Index (WORC), American Shoulder and Elbow Surgeons Shoulder Score (ASES), Constant, Oxford, and LHB scores were assessed at 2.3 ± 0.3 years postoperatively. All patients underwent clinical examination, including range of motion and force measurements. Furthermore, patients received an MRI scan of the operated shoulder two years postoperatively. Two blinded observers independently analyzed the integrity and quality of the rotator cuff on postoperative MRI using Sugaya and Castricini classifications. Clinical and radiological results were compared between both groups. Results All analyzed clinical scores, ranges of motion, and force measurements revealed no difference between both groups. Except for fatty infiltration (0° = 81% (21 of 26) vs. 68% (17 of 25); 1° = 15% (four of 26) vs. 28% (seven of 25); 2° = 4% (one of 26) vs. 4% (one of 25); and 3° = 0% (0 of 26) vs. 4% (one of 25); p < 0.01), no differences between both groups concerning the integrity (re-rupture rate = 27% (seven of 26) vs. 20% (five of 25); p = 0.39) and quality of the SSP tendon were found. Conclusions Tenodesis of the LHB performed in addition to rotator cuff repair is not associated with detrimental clinical outcomes than rotator cuff repair without surgery of the LHB. Except for fatty infiltration, which was lower in the tenodesis group, the results of the present study suggest that concomitant tenodesis of the LHB produces in patients who received rotator cuff repair have no detrimental effect in terms of clinical outcomes and re-rupture rates as well as tendon quality. Therefore, when indicated, simultaneous tenodesis of the LHB appears to be a safe and effective procedure that has no negative impact on the postoperative outcome after SSP tendon reconstruction.