[Clinical follow-up study of combined tenodesis for long head of biceps tendon lesion with massive rotator cuff tear].

Objective: To evaluate the combined tenodesis for long head of bicep tendon lesion with massive rotator cuff tear.

Methods: From January 2004 to June 2009, 41 patients of long head of bicep tendon lesion with massive rotator cuff tear were treated by arthroscopy. The follow-up period was over 12 months. There were 19 males and 22 females with an average age of 57 ± 11 year old. All patients were treated by arthroscopy with double row technique for rotator cuff tear repair and tenodesis for lesions of long head of bicep tendon. It combined the long head of bicep tendon with anterior edge of rotator cuff. The mean visual analogue scale (VAS) was 5.1 ± 23, the range of forward flexion (100 ± 55)°, external rotation (27 ± 24)° and internal rotation up to T(12) (T(5)-S(1)) level pre-operation on average. The Constant-Merly score was 50 ± 23, the University of California at Los Angeles (UCLA) score 14 ± 6 and the simple shoulder test (SST) score 4.0 ± 2.7 pre-operation on average. The strength of flexed elevation was (17 ± 20)% and strength of elbow flexion (101 ± 16)% versus the other side.

Results: All patients healed without any complication. Their outcomes improved significantly (P < 0.01). The mean VAS score improved to 1.5 ± 1.8, forward flexion (155 ± 21)°, external rotation (37 ± 24)° and post-operative internal rotation up to T(10) (T(4)-L(3)) on average. The mean Constant improved to 87 ± 13, mean UCLA 29 ± 5 and mean SST 9.3 ± 2.4. The strength of flexed elevation recovered to (68 ± 21)% post-operation. Significant differences were found in range of motion, VAS, strength and functional score (P < 0.01). No difference was observed for Mayo elbow performance score (MEPS) and elbow flexion strength at pre-operation versus post-operation.

Conclusion: The combined tenodesis with double row rotator cuff repair is an effective approach for treating lesion of long head of bicep tendon with massive rotator cuff tear.