Spontaneous rupture of the long head of the biceps (LHB) tendon represents up to 90 % of all biceps tendon ruptures and is frequently associated with pathology of the rotator cuff. Most proximal LHB tendon ruptures occur in patients over the age of 50 years and typically involve intrinsic tendon degeneration within the bicipital groove or along the biceps-labral complex. Furthermore, ‘‘iatrogenic’’ rupture of the LHB occurs following surgical tenotomy. Non-operative treatment is usually successful in these cases; however, LHB tenodesis may become necessary in selected patients with persistent symptoms such as pain, cramping, weakness and cosmetic deformity of the biceps muscle. Although infrequent, post-surgical rupture of a prior LHB tenodesis can lead to recurrent symptoms that may require revision tenodesis.

The clinical results following LHB tenodesis in patients with chronic symptomatology related to a previous LHB tendon rupture in either the primary or revision setting have been sparsely reported. Therefore, the purpose of this study was to assess the clinical results of open subpectoral LHB tenodesis in patients with chronic LHB tendon ruptures and to compare the results between primary and revision cases using an internally-derived disease-specific ‘‘Subjective Proximal Biceps Score’’ (SPBS). We hypothesized that patients who underwent primary tenodeses would demonstrate greater symptomatic improvement when compared to those who underwent revision tenodeses.

Full Article: Chronic rupture of the long head of the biceps tendon: comparison of 2-year results following primary versus revision open subpectoral biceps tenodesis