Arthroscopic Tenotomy of the Long Head of the Biceps Tendon.

The tendon of the long head of the biceps (LHB) can become a source of pain and subsequent shoulder disability as due to several pathologies, such as tendonitis, synovitis, subluxation, dislocation, and hypertrophy with intra-articular entrapment. Operative treatment for a symptomatic LHB tendon includes tenotomy or tenodesis; however, there is considerable debate over which technique is optimal. The decision to use one technique over the other depends on patient factors (age, health condition, activity, and hope), structural compromise to the biceps tendon, and concomitant shoulder pathology. The benefits of tenotomy are technical ease, minimal risk of persistent tenosynovitis, no need for an implant, postoperative protection, and tendon-bone healing. Past studies have demonstrated either no difference or a difference less than the reported minimal clinically important difference in postoperative outcome scores between rotator cuff repair (RCR) with LHB tenotomy and tenodesis. Additionally, there were no differences in postoperative patient satisfaction, fatigue-related cramping or elbow flexion strength after RCR with LHB tenotomy or tenodesis. However, there are significant differences in the degree of cosmetic deformity and forearm supination strength between RCR with LHB tenotomy and tenodesis. LHB tenotomy is a viable option for treatment of symptomatic LHB tendon for the patients without a high demand for cosmetic deformity and forearm supination strength. [ABSTRACT FROM AUTHOR]