Tenotomy Versus no Tenotomy LHB in Rotator Cuff Repair

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.

Completed

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Key information

Conditions

Long Head of Biceps Brachii Lesions Rotator Cuff Injuries Rotator Cuff Tears Rupture Shoulder Injuries Tendon Injuries Wounds and Injuries

Age range

40 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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

Treatment and study plan

Rotator Cuff Repair

Procedure

ROTATOR CUFF REPAIR

Primary outcomes

Constant Murley

Time frame: 24 month

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)

Secondary outcomes

ASES

Time frame: 24 MONTHS

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).
cross sectional area of the LHBT

Time frame: 24 months

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

Sponsors and collaborators

Lead sponsor

Consorci Sanitari de Terrassa

Other

Registry information

Official study title

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

Important dates

Study start: 2015
Primary completion: 2017
Study completion: 2017
First posted: Dec 17, 2025
Registry last updated: Dec 17, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.

Completed