Arthroscopic isolated long head of biceps tenotomy in patients with degenerative rotator cuff tears: mid-term clinical r
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ORIGINAL ARTICLE
Arthroscopic isolated long head of biceps tenotomy in patients with degenerative rotator cuff tears: mid‑term clinical results and prognostic factors Egbert J. D. Veen1,2 · Ashvin V. Boeddha1 · Ronald L. Diercks2 · Ydo V. Kleinlugtenbelt1 · Ellie B. M. Landman1 · Cornelis T. Koorevaar1 Received: 12 March 2020 / Accepted: 1 September 2020 © The Author(s) 2020
Abstract Introduction The long head of biceps tendon is frequently involved in degenerative rotator cuff tears. Therefore, this study explored the clinical results of an isolated biceps tenotomy and identified prognostic factors for improvement in pain and function. Materials and methods Between 2008 and 2017, an arthroscopic isolated biceps tenotomy was performed on 64 patients with a degenerative rotator cuff tear (> 65 years). Primary outcome was patient-perceived improvement in pain and function. Potential prognostic factors for improvement in pain and function were identified. Results A perceived improvement in pain was reported in 78% of the patients at three months after surgery and in 75% at a mean follow-up of 4.2 years (1–7 years; n = 55). A perceived improvement in function was observed in 49% of patients at three months and in 76% of patients at follow-up. Patients with a preoperatively normal acromiohumeral distance (> 10 mm) reported an improvement in pain and function significantly more often. Retraction of the supraspinatus tendon Patte 3 was significantly associated with worse functional outcome. Conclusions A biceps tenotomy can be a reliable treatment option for patients with symptomatic degenerative cuff tears who fail conservative treatment and have a normal acromiohumeral distance (> 10 mm). Keywords Long head of biceps tendon · Biceps · Tenotomy · Rotator cuff tears · Degenerative · Arthroscopy
Introduction Degenerative rotator cuff tears are common in the aging population, and most tears are asymptomatic. Some patients may develop symptoms, but conservative treatment is still effective in most cases [1–3]. When conservative treatment fails, operative treatment can be challenging. Although rotator cuff repair is an effective procedure in the younger population, age is associated with less satisfactory results and a higher rate of re-tears [4, 5]. French orthopedic surgeons * Egbert J. D. Veen [email protected] 1
Department of Orthopedic Surgery and Traumatology, Deventer Hospital, P.O. Box 5001, 7400 GC Deventer, Nico Bolkesteinlaan 75, The Netherlands
Department of Orthopedic Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
2
popularized arthroscopic tenotomy of the long head of biceps tendon (LHB) as a treatment option for patients with degenerative rotator cuff tears [6]. A tenotomy of the long head of biceps is found to produce an earlier pain relief compared to tenodesis [7] and minimal residual symptoms [8]. Also biceps surgery in combination with a rotator cuff repair, superior outcome is seen [9]. Both Walch et al. and Boileau et al. reported sat
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