Superior capsular reconstruction using the long head of the biceps does not negatively affect outcomes in terms of pain or stiffness in the repair of large rotator cuff tears at 6 months post-operatively: matched-pair design for equivalence study

Steven Roulet; Philippe Delsol ; Pascal Garaud; John Swan; Johannes Barth

DOI: 10.70885/hmsj.2024.11.002

Abstract

Purpose: The long head of the biceps tendon (LHBT) is considered a pain generator, and some concerns could be raised if used for superior capsule reconstruction (SCR). The goal is to analyze, in a study of equivalence, the complications and the clinical outcomes in patients who underwent a repair associated with SCR using the LHBT for an irreparable supraspinatus tear (with reparable infraspinatus and subscapularis tendons) and those with an isolated repair in case of reparable rotator cuff tear.Methods: Twenty-six patients (27 shoulders) in the "SCR" group were matched to twenty-seven patients (27 shoulders) in the "Isolated Repair" group, all Collin type C or D. Follow-up evaluation included complications, pain, subjective shoulder value (SSV), corticosteroid infiltrations and range of motion (ROM). An ultrasound at 6 months was performed to assess tendon healing.Results: Both techniques were equivalent for all ROM at 6 months, average pain, and pain improvement post-operatively. The average SSV and the SSV improvement were significantly greater for the SCR group. There were no differences in tendon healing or frequency of postoperative injections.Conclusions: The main finding of this study is that using the LHBT does not add morbidity such as pain or stiffness, despite the proximal portion being considered as a pain generator. SCR using the LHBT does not cause any additional complications and clinical outcomes are equivalent at 6 months to those of an isolated repair of rotator cuff tears.Keywords: Arthroscopic; Equivalence study; Long head of the biceps; Rotator cuff tears; Superior capsular reconstructionStudy design: Retrospective comparative studyLevel of evidence: Level IIIhttps://doi.org/10.70885/hmsj.2024.11.002

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