Abstract

Background:Lesions of the long head of the biceps (LHB) tendon are frequently associated with massive rotator cuff tears (RCT) and may be responsible for shoulder pain and disability.Objective:This study aimed to evaluate functional outcomes of arthroscopic biodegradable spacer implantation with or without biceps tenotomy as treatment for persistent shoulder dysfunction and pain due to a massive irreparable RCT.Methods:A total of 48 patients were implanted with the subacromial spacer using arthroscopic approach with or without biceps tenotomy. All patients were assessed for up to 12 months post-implantation and 18 patients were assessed for at least 24 months (and a maximum of 40 months). Improvement in shoulder function was assessed using Constant score.Results:Subacromial spacer implantation was performed arthroscopically in 48 patients. The mean total Constant score increased from 36 at baseline to 67 points at 12 months post implantation. Patients who underwent LHB tenotomy in addition to the subacromial spacer presented similar improvement of their shoulder function and score compared to the group that was treated with the spacer alone.Conclusion:Current study demonstrates that spacer implantation in this patient population provides significant improvement in function and decreases the pain. Additional LHB tenotomy did not influence the postoperative results during the follow-up.

Highlights

  • Massive, degenerative rotator cuff (RC) tears can be disabling due to severe pain and/or weakness of the shoulder

  • Patients who underwent long head of the biceps (LHB) tenotomy in addition to the subacromial spacer presented similar improvement of their shoulder function and score compared to the group that was treated with the spacer alone

  • Current study demonstrates that spacer implantation in this patient population provides significant improvement in function and decreases the pain

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Summary

Introduction

Degenerative rotator cuff (RC) tears can be disabling due to severe pain and/or weakness of the shoulder. Based on many clinical studies, isolated arthroscopic biceps tenotomy or tenodesis is considered as an acceptable option for the treatment of RC tears in particular patients [14, 15]. It does not improve shoulder strength, tenotomy or tenodesis reported to reduce pain and improve the functional range of motion with a high degree of patient satisfaction [14, 15]. Lesions of the long head of the biceps (LHB) tendon are frequently associated with massive rotator cuff tears (RCT) and may be responsible for shoulder pain and disability

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