Shoulder Long Head Biceps Tendon Pathology Is Associated With Increasing Rotator Cuff Tear Size

Vittorio Candela; Jacopo Preziosi Standoli; Stefano Carbone; Marco Rionero; Stefano Gumina

doi:10.1016/j.asmr.2021.07.013

Shoulder Long Head Biceps Tendon Pathology Is Associated With Increasing Rotator Cuff Tear Size

Arthrosc Sports Med Rehabil. 2021 Aug 27;3(5):e1517-e1523. doi: 10.1016/j.asmr.2021.07.013. eCollection 2021 Oct.

Authors

Vittorio Candela^{1

2}, Jacopo Preziosi Standoli³, Stefano Carbone³, Marco Rionero^{1

2}, Stefano Gumina^{4

2}

Affiliations

¹ Department of Anatomical, Histological, Forensic Medicine and Orthopaedics Sciences, Sapienza University of Rome, Rome, Italy.
² Istituto Clinico Ortopedico Traumatologico, Latina, Italy.
³ Sapienza Univerisity, Sant'Andrea Hospital (X.X.X. ), Rome, Italy.
⁴ Shoulder Unit, San Feliciano Clinic, Rome, Italy.

Abstract

Purpose: To evaluate the association between rotator cuff tear (RCT) size and long head biceps tendon (LHBT) pathology.

Methods: We retrospectively enrolled 202 consecutive patients (114 women and 88 men with mean age at surgery of 62.14 years [SD, 7.73]) who underwent arthroscopic rotator cuff repair for different sized full-thickness RCTs. LHBT pathology was evaluated considering the presence of inflammation, section alteration, loss of integrity, dislocation, dynamic instability, and absence. The site of LHBT pathology was evaluated considering 3 portions: (1) the insertional element; (2) the free intra-articular portion; (3) the part that enters the intertubercular groove. Statistics were evluated.

Results: The LHBT was absent in 22 cases (10.9%): 2, 4, 15, and 1 patients with small, large, massive, and subscapularis RCTs, respectively. A significant correlation was found between the prevalence of LHBT absence and massive RCTs (P < .001). In 53 patients (26%), there was a healthy LHBT; a healthy LHBT was present in 47%, 20% and 8% of small, large and massive RCTs, respectively. A significant correlation between LHBT inflammation, section alteration, loss of integrity, and RCT severity was found (P < .001, P < .001, and ). The insertional portion was the most involved (57% of cases); RCT severity was significantly associated with the number of involved portions (P < .001).

Conclusions: Shoulder LHBT pathology is associated with increasing rotator cuff tear size.

Clinical relevance: Surgeons should be aware that biceps pathology is particularly prevalent in patients with larger RTCs.