The effect of biceps tenotomy on superior humeral migration in arthroscopic repaired full-thickness supraspinatus tears

Abstract

Lesions of the long head of the biceps (LHB) tendon are a prevalent injury that frequently coexists with rotator cuff injuries. This study aimed to assess the effect of supraspinatus (SST) repair with concurrent LHB tenotomy on superior migration of the humeral head. The acromiohumeral distance (AHD) was determined via ultrasound to evaluate the superior migration of the humeral head. The study population was retrospectively recruited from patients who underwent unilateral arthroscopic repair of isolated degenerative full-thickness SST tears between January 2017 and December 2019. Patients were divided into 2 subgroups based on whether they underwent LHB tenotomies during arthroscopy. While 37 patients underwent arthroscopic single-row SST repair, the other 33 patients underwent arthroscopic single-row SST repair with LHB tenotomy. The subject group consisted of people who had undergone arthroscopic shoulder surgery. Contralateral shoulders without rotator cuff injuries were included in the control group. The AHD and SST thicknesses of patients were examined via the ultrasound in both groups and subgroups. The mean age in the SST repair group was 55.52±4.58 years (range, 46-63 years), whereas it was 58.24±3.98 (range, 52-73 years) in the SST repair+LHB tenotomy group. In the SST repair group, 57.6% of patients were female and 42.4% were male, whereas 56.8% and 43.2% were in the SST repair+LHB tenotomy group, respectively. The mean body mass index was 28.06±1.31 kg/m2 (range, 25.7-31.2 kg/m2) in the SST repair group and 28.95±1.79 kg/m2 in the SST repair+LHB tenotomy group. Groups were not different for sex, surgery side, dominant side, tear size, and follow-up time; however, the SST repair+LHB tenotomy group had significantly higher mean age and body mass index than the SST repaired group. The mean AHD value and SST thickness were significantly less in both the rotator cuff repair group and the rotator cuff repair+LHB tenotomy group compared to the healthy shoulder. The mean AHD value was significantly lower in the SST repaired+LHB tenotomy group than in the SST repair group (P=.02). The AHD was narrowed in patients who underwent LHB tenotomy and radiologically demonstrated the depressor effect of the LHB tendon on the humeral head. As a secondary outcome, we demonstrated that regardless of tenotomy, AHD could not be restored in patients who underwent arthroscopic single-row SST repair.