ArticleJSES international2025
The impact of biceps tenotomy/tenodesis on Popeye sign incidence and functional outcome.
Article in JSES international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed.
- Arthroscopic Bicortical Biceps Anchorage: An Arthroscopic-Assisted Technique for Subpectoral Biceps Tenodesis.Arthroscopy techniques · 2026Article
- The Popeye sign: beyond the bulge-a proposal for a standardized definition and classification.Clinics in shoulder and elbow · 2026Article
- Comparison of subacromial volume and clinical parameters of patients who underwent biceps tenotomy or tenodesis due to long head of biceps tendon pathologies during rotator cuff repair surgery.Acta orthopaedica et traumatologica turcica · 2026Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Literature reports varied incidences and clinical relevance of Popeye's sign in patients who underwent biceps tenotomy or tenodesis. There is no consensus according to indication and outcome. We aimed to evaluate the frequency of the Popeye sign in a large cohort of patients concomitantly treated with an arthroscopic rotator cuff repair (ARCR). We assessed the effect on the clinical outcome based on biceps tendon treatment and Popeye sign. Methods: A cohort of 973 primary ARCR patients from different Swiss and German orthopedic clinics was prospectively documented for up to 24 months postoperatively. All patients who received biceps tendon treatment were included in this study. We assessed Popeye sign occurrence across groups treated either with tenodesis or tenotomy. Additionally, we compared clinical and radiological outcome between Popeye/non-Popeye and tenotomy/tenodesis groups. Results: Eight hundred patients were evaluated, of which 55% (n = 442) underwent tenodesis and 45% (n = 358) received tenotomy of the long head of the biceps tendon. Mean age of the tenodesis group was significantly lower than that of the tenotomy group (55 ± 9 and 61 ± 8 years, Conclusion: Patients with tenotomy of the biceps tendon are 3 times more likely to develop a Popeye sign compared to tenodesis. Popeye sign after ARCR seems to have no relevant effect on the clinical outcome and pain even though the subjective shoulder value was lower in patients with Popeye sign.
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