Tenotomy Versus no Tenotomy LHB in Rotator Cuff Repair

Tenotomy Versus no Tenotomy of the Long Head of the Biceps in Rotator Cuff Repair: Clinical-functional Analysis and Ultrasound Evaluation

The function of the long head of the biceps tendon (LHBT) in the glenohumeral joint generates controversy among researchers. For some, the tendon does not have a significant function in the shoulder, while others consider it acts as a depressor of the humeral head and a stabilizer of the joint. These functions may be enhanced in cases of rotator cuff injuries, where compensatory hypertrophy and/or instability of the LHBT can occur, which can also be a source of pain. One of the imaging techniques used for diagnosing these injuries is ultrasound.

Initially, G. Walch proposed tenotomy of the LHBT in massive rotator cuff tears to improve pain and, in some cases, shoulder function. Currently, many authors advocate tenotomy of the LHBT as an adjunct to rotator cuff repair to avoid postoperative pain. However, there is no evidence that this procedure improves the clinical outcomes of isolated rotator cuff repair.

Based on the pathophysiology of the LHBT associated with rotator cuff injuries and the current trend to perform tenotomies in conjunction with cuff repair, the objectives of this doctoral thesis project were:

To compare the clinical and imaging outcomes of arthroscopic rotator cuff repairs with and without LHBT tenotomy.

To analyze the position and cross-sectional area of the LHBT in the bicipital groove using ultrasound in cases with and without tenotomy.

Study Overview

• Status: Completed
• Conditions: Rotator Cuff Tears; Long Head of Biceps Brachii Lesions
• Intervention / Treatment: Procedure: ROTATOR CUFF REPAIR

• Study Type: Interventional
• Enrollment (Actual): 60
• Phase: Not Applicable

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age between 40 and 65 years
• Partial supraspinatus tears (≥ 50% thickness)
• Complete supraspinatus tears ≤ 3 cm in the coronal plane
• Muscle atrophy less than stage 2 according to Thomazeau
• Presence of the LHBT in the bicipital groove

Exclusion Criteria:

• Patients younger than 40 or older than 65 years
• LHBT rupture
• Partial supraspinatus tears < 50% thickness
• Supraspinatus tears > 3 cm
• Tears of other rotator cuff tendons, with or without supraspinatus involvement
• Traumatic tears with surgery performed less than 3 months after injury
• Muscle atrophy ≥ stage 2 Thomazeau
• Associated degenerative glenohumeral pathology (> Samilson 1)
• Previous shoulder surgeries
• Previous shoulder infections
• Associated peripheral neurological injuries
• Degenerative neurological conditions
• Patients who refused to sign informed consent

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Placebo Comparator: NO TENOTOMY; NO TENOTOMY OF LHBT + ROTATOR CUFF REPAIR	Procedure: ROTATOR CUFF REPAIR; ROTATOR CUFF REPAIR
Experimental: TENOTOMY; TENOTOMY OF LHBT + ROTATOR CUFF REPAIR	Procedure: ROTATOR CUFF REPAIR; ROTATOR CUFF REPAIR

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Constant Murley	100-point standardized tool for assessing shoulder function, comprising four domains Pain (0-15 points) daily life activity (0-20 points) range of motion (0-40 points) strenght (0-25 points) 0 (the worst) - 100 (the best)	24 month

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
ASES	The ASES score (American Shoulder and Elbow Surgeons score) is a 100-point questionnaire used to assess shoulder function and pain, with a higher score indicating better outcomes. From 0 (worst) to 100 (best).	24 MONTHS
cross sectional area of the LHBT	Ultrasound Imaging: Integrity of the supraspinatus tendon (SST) repair, presence of the long head of the biceps tendon (LHBT) in the bicipital groove (BG), and cross-sectional area of the LHBT at three levels of the BG (proximal, middle, and distal). mesured in mm2	24 months

Collaborators and Investigators

• Sponsor: Consorci Sanitari de Terrassa

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2015
• Primary Completion (Actual): June 30, 2017
• Study Completion (Actual): June 30, 2017

Study Registration Dates

• First Submitted: September 30, 2025
• First Submitted That Met QC Criteria: December 4, 2025
• First Posted (Actual): December 17, 2025

Study Record Updates

• Last Update Posted (Actual): December 17, 2025
• Last Update Submitted That Met QC Criteria: December 4, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: tenotomy; rotator cuff tears; long head biceps; no tenotomy
• Additional Relevant MeSH Terms: Shoulder Injuries; Wounds and Injuries; Rupture; Tendon Injuries; Rotator Cuff Injuries
• Other Study ID Numbers: 02-14-105-018

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No