Innovations in Rotator Cuff Repair: LHBT Tenodesis Accelerates Postoperative Functional Recovery
Listed in
This article is not in any list yet, why not save it to one of your lists.Abstract
Rotator cuff tear patients are often accompanied by long head biceps tendon (LHBT) pathology, but the management strategy for LHBT during arthroscopic rotator cuff repair (ARCR) remains controversial. This study aimed to compare the therapeutic efficacy between isolated rotator cuff repair and LHBT tenodesis with tendon release. A retrospective cohort of 60 patients with rotator cuff tears and LHBT inflammation was included, divided into a control group (isolated repair, 30 cases) and an experimental group (LHBT tenodesis with tendon release, 30 cases). Functional scores (Constant, ASES), pain (VAS), and range of motion (ROM) were assessed preoperatively and at 1, 3, and 6 months postoperatively. The results indicated that the experimental group demonstrated significantly greater improvement in joint ROM at 3 months postoperatively compared to the control group (flexion: 159.97° vs. 156.43°, p < 0.01; external rotation: 66.30° vs. 59.07°, p < 0.01). Functional scores improved more rapidly in the experimental group between 1 and 3 months postoperatively (Constant score at 1 month: 68.50 vs. 63.40, p < 0.01), and the VAS score at 3 months was significantly lower in the experimental group (2.07 vs. 2.40, p < 0.01). However, at 6 months postoperatively, the functional scores of both groups converged (Constant score: 89.83 vs. 91.33, p = 0.01), and there was no significant difference in pain relief. The study suggests that LHBT tenodesis with tendon release significantly enhances early postoperative functional recovery and pain alleviation. This mechanism may be related to the increased dynamic stability of the shoulder joint due to LHBT fixation and the reduction of proximal neurogenic pain signals following tendon release. However, long-term outcomes are comparable to isolated rotator cuff repair, indicating that clinical decision-making should be individualized based on patient age, activity level, and the degree of LHBT pathology.
