Biceps Tendon Tenodesis without Tenotomy: A Method of Augmenting Partial Repairs of Massive Rotator Cuff Tears

Abstract

To determine if biceps tendon tenodesis without tenotomy , when used in addition to partial repairs of massive rotator cuff tears, allowed for improved patient satisfaction outcomes without significant loss of motion. 15 patients with massive cuff tears(>5 sq. cm.) underwent repair in addition to tenodesis of the long head biceps tendon. The long head origin was not cut and therefore left intact. The follow up period was a minimum of 12 months with a maximum of 24 months. Preoperative and follow up results were measured by Oxford Pain Scores, American Shoulder and Elbow Surgeons Score (ASES), and Constant Shoulder Score. Range of motion loss was measured as a percentage of the combined range of motion of the opposite shoulder. The averaged Constant Score improved from 17.8 to 75.3. ASES improved from 16.3 to 77.4. Oxford Pain Score improved from 14 to 33. The average combined loss of motion was 9 degrees. No patient had pain in the biceps tendon groove at final evaluation. Tenodesis without tenotomy of the biceps tendon long head when used in addition to partial repair of massive rotator cuff tears, may help to improve patiient satisfaction scores. The tenodesed long head may act as a restraint to superior humeral head migration, thereby reducing some of the stresses on the competed partial rotator cuff repair. This construct however, could result in a tethering of the shoulder and thereby result in significant loss of motion. The average combined loss of only 9 degrees had minimal clinical significance.