Clinical follow up study of arthroscopic treatment of rotator cuff tear with concomitant biceps long head lesion

Abstract

Objective To evaluate the clinical and functional outcomes in a cohort of rotator cuff tear patients who underwent arthroscopic rotator cuff repair combined with biceps tenodesis using percutaneous intra-articular transtendon technique (PITT). Methods Thirty patients with rotator cuff tear who had concomitant biceps pathology or instability were treated between March 2006 and March 2008 with arthroscopic rotor cuff repair and biceps tenodesis using PITT technique. American Shoulder and Elbow Surgeons' score (ASES), Constant-Murley score and Visual Analog scale pain score were adopted for postoperative shoulder function evaluations. The cosmetic appearance and biceps strength were also evaluated. Results Postoperative follow up period was 23 months on average (range 12 to 37 months). ASES of the 30 shoulders was 43.8 preoperatively and 94.7 postoperatively. Constant-Murley score was 52.8 and 94.1 respectively. VAS score was 5.5 preoperatively and 0.6 postoperatively. The pre-and post-operative differences of the three scores were all statistically significant ( P < 0.01). None of the 30 patients had Popeye deformity and biceps spasm at final follow up. No significant biceps strength difference was found between the operated side and the contralateral side. Twenty-nine patients were satisfied with the functional outcome. Conclusion PITT is a safe and reliable treatment option for biceps pathology in rotator cuff tear patients. Shoulder pain relief and biceps strength maintenance can be well expected without any cosmetic deformity. Key words: Shoulder joint; Arthroscopes; Follow-up studies; Rotator cuff tears