Surgical technique and functional results of irreparable cuff tears reconstructed with the long head of the biceps tendon.
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Irreparable Rotator Cuff Reconstruction with the Long Head of the Biceps Tendon
This clinical study evaluates the functional outcomes of patients treated with an open surgical technique utilizing the long head of the biceps tendon (LHBT) for irreparable rotator cuff tears. The primary objective was to determine the efficacy of this specific reconstruction method in restoring shoulder stability and alleviating pain when standard repair is not feasible.
Patient Demographics and Study Methodology
Between May 1992 and January 1997, 14 patients underwent surgical reconstruction at our clinic for irreparable rotator cuff tears. To ensure the reliability of the data, patients were monitored for a minimum follow-up period of 26 months, with a mean follow-up duration of 40.2 months. Clinical performance was strictly measured using the Constant’s functional score both preoperatively and postoperatively.
Intraoperative Findings and Surgical Technique
During the surgical procedures, specific pathological changes were observed in the biceps tendon structure. The following findings and interventions were documented for all 14 cases:
- Tendon Hypertrophy: The long head of the biceps tendon was found to be hypertrophied in all 14 shoulders.
- Subluxation: In 10 of the cases, the tendon was also found to be subluxated.
- Surgical Procedure: The enlarged biceps tendon was surgically re-seated onto the center of the uncovered humeral head region.
- Repair and Tenodesis: Following re-seating, biceps tendon to cuff tendon repair and biceps tenodesis were performed in all patients.
Clinical Outcomes and Functional Recovery
The transition from preoperative status to final follow-up showed a significant improvement in shoulder function. The results demonstrate a clear shift from "poor" to "good" functional categories according to the Constant's scoring system.
| Evaluation Period | Mean Constant's Score | Clinical Grade |
|---|---|---|
| Preoperative | 46.7 Points | Poor |
| Postoperative (Final Follow-up) | 75.35 Points | Good |
Conclusion: Success Rates of the LHBT Technique
The study achieved satisfactory results in 85.7% of the patients, indicating a high success rate for this intervention. These clinical findings suggest that utilizing the long head of the biceps tendon in the reconstruction of irreparable cuff tears is a viable surgical strategy. This technique effectively facilitates the recovery of a painless and functional shoulder, providing a reliable solution for complex rotator cuff pathologies.
