Is augmentation with the long head of the biceps tendon helpful in arthroscopic treatment of irreparable rotator cuff tears?

Background: Although various surgical techniques have been used to treat irreparable rotator cuff tears (RCTs), debate remains regarding which treatment is most effective. The purpose of our study was to compare the outcomes of partial rotator cuff repair versus repair with augmentation of the tenotomized long head of the biceps tendon (LHBT). Methods: This study included 76 patients with large to massive RCTs. Arthroscopic rotator cuff repair with LHBT augmentation was performed in 39 patients (group I), while partial repair was performed in 37 patients (group II). Clinical and functional outcomes were compared with a visual analog scale for pain and the American Shoulder and Elbow Surgeons score, Constant score, and Korean Shoulder Score. Magnetic resonance imaging was performed 12 months after surgery. Results: The mean follow-up period was 29.6 +/- 7.8 months (range, 24-51 months). Significant improvements in pain and clinical scores were observed in both groups at the last follow-up. However, there were no significant differences in pain, clinical scores, or range of motion between the 2 groups at any time point. Retears were observed in 16 patients in group I (41.0%) and 14 in group II (37.8%, P = .78). Augmented LHBT pathology was observed in 10 patients (25.6%). Conclusions: Both partial repair and repair with LHBT augmentation were effective in improving clinical and radiologic outcomes. No significant differences in clinical outcomes or repaired cuff integrity were observed between the groups. The investment of operation time and effort in augmenting the LHBT in the treatment of irreparable RCTs is not recommended. (c) 2018 Published by Elsevier Inc. on behalf of Journal of Shoulder and Elbow Surgery Board of Trustees.