Symptomatic chronic long head of biceps rupture: Surgical results

PURPOSE: Chronic rupture of the long head of biceps (LHB) tendon is usually asymptomatic. However, some active patients suffer with long-term cramping pain associated with repetitive biceps use. The aim of this study is to review the outcomes of biceps tenodesis performed for chronic LHB ruptures. MATERIALS AND METHODS: We performed a retrospective review of 11 consecutive patients who underwent biceps tenodesis for symptomatic chronic LHB ruptures over a 4-year period. RESULTS: There were 10 men and one woman with an average age at surgery of 41 years (range 23-65). The mean follow-up was 29 months (range 6-60). In five cases a tendon was still identifiable and suitable for repair with an ‘in-bone’ interference screw. However, in six cases the tendon was not possible to tenodese with an interference screw. In these cases we used an ‘on-bone’ technique with suture anchors. All, except one, patients reported improvement in their arm pain (78%), strength (74%) and appearance. All, except one, were glad to have had the surgery. CONCLUSIONS: Symptomatic chronic LHB ruptures improve with a biceps tenodesis procedure. Due to the chronicity of the injury and possible degeneration of the tendon, a suitable tendon for ‘in-bone’ tenodesis may not be possible. In these cases an ‘on-bone’ footprint repair with suture anchors achieves good results. LEVEL OF EVIDENCE: IV (retrospective case series).