Comparison supraspinatus tendon retear rate after tenotomy or tenodesis or no procedure of the long head of the biceps tendon on Patte 2-3 types patients

Background: Rotator cuff retear after arthroscopic consistently challenges medical staff and patients. The operation method affects the shoulder function and tendon healing. How to deal with the long head of the biceps tendon (LHBT) in the arthroscopic surgery is a controversial issue. We compared supraspinatus tendon retear rate after tenotomy or tenodesis or no procedure of the LHBT in shoulder arthroscopic surgery on Patte 2-3 types patients. Methods: The authors reviewed the records of 108 patients who had magnetic resonance imaging (MRI) before and 3 months after the surgery. The mean age was 56.39±7.87 years (range, 38-73 years), and 71 patients were women (65.7%). The surgical methods of LHBT include tenotomy, tenodesis (simple tenodesis, tenotomy with tenodesis) and no procedure. Retraction of the supraspinatus tendon was graded according to Patte classification. The postoperative tendon integrity was evaluated by Sugaya classification on MR coronal T2WI. The classifications of Sugaya 4 and 5 were considered as tendon retear. The patients basic information and MR manifestations before surgery were compared in different LHBT treatments. Comparing the difference in the rotator cuff retear rate among tenotomy, tenodesis versus no procedure of LHBT was evaluated by Chi-square test. Results: Among the 108 patients, in the LHBT surgical treatments, 41 patients underwent no procedure, 38 underwent tenotomy and 29 underwent tenodesis. The rotator cuff retear rate was 18.5% in all the patients. There were statistic differences in rotator cuff retear rate between no procedure and tenotomy or tenodesis patients in the LHBT.(P=0.032) There was a lower tendon retear rate in tenotomy and tenodesis patients than no procedure of LHBT. Between tenotomy and tenodesis patients, there was no statistic differences in the rotator cuff retear rate. (P=0.485) Conclusions: For the LHBT management of the supraspinatus tendon tear patients on Patte 2-3 types, both tenotomy and tenodesis of LHBT had good outcomes in the rotator cuff repair integrity after the shoulder arthroscopic. No procedure of LHBT had a higher supraspinatus tendon retear rate after the arthroscopic surgery.