Long head of biceps tendon augmentation in rotator cuff repair enhances tendon healing, shoulder function and patient‐reported outcomes one‐year post‐surgery

Abstract Purpose The aim is to determine the effect on healing and functionality of patients after 1 year of biceps augmentation of a rotator cuff repair (RCR) compared to RCR plus long head of the biceps (LHB) tenotomy. In addition, to analyse the main factors involved in the recovery after the sur...

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Main Authors: Pablo Cañete San Pastor, Inmaculada Prosper Ramos, Alberto Garcia Roig, Joan Andreu Safont
Format: Article
Language:English
Published: Wiley 2024-10-01
Series:Journal of Experimental Orthopaedics
Subjects:
Online Access:https://doi.org/10.1002/jeo2.70033
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author Pablo Cañete San Pastor
Inmaculada Prosper Ramos
Alberto Garcia Roig
Joan Andreu Safont
author_facet Pablo Cañete San Pastor
Inmaculada Prosper Ramos
Alberto Garcia Roig
Joan Andreu Safont
author_sort Pablo Cañete San Pastor
collection DOAJ
description Abstract Purpose The aim is to determine the effect on healing and functionality of patients after 1 year of biceps augmentation of a rotator cuff repair (RCR) compared to RCR plus long head of the biceps (LHB) tenotomy. In addition, to analyse the main factors involved in the recovery after the surgery. Methods A prospective, comparative, non‐randomized study (Level of Evidence III) was conducted. Patients with repairable rotator cuff tears were allocated to either the control group, with a double row transosseous equivalent RCR with LHB tenotomy, or the RCR+augmentation with LHB group. Patients were evaluated for radiological (MRI), clinical (cuff size, Patte and Goutallier scales) and functional variables (Constant and American Shoulder and Elbow Surgeons [ASES] scales) before the intervention. At 1‐year follow‐up cuff healing was confirmed through MRI and functional evaluation with Constant, ASES, simple shoulder test [SST] and Disabilities of the Arm, Shoulder and Hand scales. Results Seventy‐seven patients underwent control or RCR+augmentation with LHB, there were no preoperative differences between the groups. After 1 year of the surgery, re‐rupture occurred in 38.5% and 16% of the patients in control and RCR+augmentation with LHB groups, respectively (p = .026). Total functionality was higher (p < .05) in RCR+augmentation with LHB than in the control group: Constant, SST and ASES scales. Among the explored factors involved in healing, re‐rupture occurred in 100% of the cases with high fatty degeneration. Besides, higher initial functionality (Constant scale) and RCR+augmentation with LHB increased the odds of healing (odds ratio [OR] = 1.12 [1.04–1.21]; OR = 5 [1, 61], respectively), while higher cuff length had a detrimental effect (OR = 0.92 [0.85–0.99]). Conclusion RCR+augmentation with LHB achieves a higher healing percentage and a better functional evolution than RCR+LHB tenotomy, 1 year after cuff repair. Fatty degeneration, cuff length and initial functionality are the main factors involved in cuff healing. Level of Evidence Level III randomized controlled trial.
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spelling doaj-art-3e61c2bc07704e188bd616ff068f5df02025-08-20T02:58:21ZengWileyJournal of Experimental Orthopaedics2197-11532024-10-01114n/an/a10.1002/jeo2.70033Long head of biceps tendon augmentation in rotator cuff repair enhances tendon healing, shoulder function and patient‐reported outcomes one‐year post‐surgeryPablo Cañete San Pastor0Inmaculada Prosper Ramos1Alberto Garcia Roig2Joan Andreu Safont3Doctoral School, Catholic Unversity of Valencia San Vicente Martir Hospital de Manises Manises Valencia SpainHospital de Manises Valencia SpainHospital de Manises Valencia SpainHospital de Manises Valencia SpainAbstract Purpose The aim is to determine the effect on healing and functionality of patients after 1 year of biceps augmentation of a rotator cuff repair (RCR) compared to RCR plus long head of the biceps (LHB) tenotomy. In addition, to analyse the main factors involved in the recovery after the surgery. Methods A prospective, comparative, non‐randomized study (Level of Evidence III) was conducted. Patients with repairable rotator cuff tears were allocated to either the control group, with a double row transosseous equivalent RCR with LHB tenotomy, or the RCR+augmentation with LHB group. Patients were evaluated for radiological (MRI), clinical (cuff size, Patte and Goutallier scales) and functional variables (Constant and American Shoulder and Elbow Surgeons [ASES] scales) before the intervention. At 1‐year follow‐up cuff healing was confirmed through MRI and functional evaluation with Constant, ASES, simple shoulder test [SST] and Disabilities of the Arm, Shoulder and Hand scales. Results Seventy‐seven patients underwent control or RCR+augmentation with LHB, there were no preoperative differences between the groups. After 1 year of the surgery, re‐rupture occurred in 38.5% and 16% of the patients in control and RCR+augmentation with LHB groups, respectively (p = .026). Total functionality was higher (p < .05) in RCR+augmentation with LHB than in the control group: Constant, SST and ASES scales. Among the explored factors involved in healing, re‐rupture occurred in 100% of the cases with high fatty degeneration. Besides, higher initial functionality (Constant scale) and RCR+augmentation with LHB increased the odds of healing (odds ratio [OR] = 1.12 [1.04–1.21]; OR = 5 [1, 61], respectively), while higher cuff length had a detrimental effect (OR = 0.92 [0.85–0.99]). Conclusion RCR+augmentation with LHB achieves a higher healing percentage and a better functional evolution than RCR+LHB tenotomy, 1 year after cuff repair. Fatty degeneration, cuff length and initial functionality are the main factors involved in cuff healing. Level of Evidence Level III randomized controlled trial.https://doi.org/10.1002/jeo2.70033cuff re‐rupturelong head of the bicepsrotator cuff repairsuperior capsular reconstruction
spellingShingle Pablo Cañete San Pastor
Inmaculada Prosper Ramos
Alberto Garcia Roig
Joan Andreu Safont
Long head of biceps tendon augmentation in rotator cuff repair enhances tendon healing, shoulder function and patient‐reported outcomes one‐year post‐surgery
Journal of Experimental Orthopaedics
cuff re‐rupture
long head of the biceps
rotator cuff repair
superior capsular reconstruction
title Long head of biceps tendon augmentation in rotator cuff repair enhances tendon healing, shoulder function and patient‐reported outcomes one‐year post‐surgery
title_full Long head of biceps tendon augmentation in rotator cuff repair enhances tendon healing, shoulder function and patient‐reported outcomes one‐year post‐surgery
title_fullStr Long head of biceps tendon augmentation in rotator cuff repair enhances tendon healing, shoulder function and patient‐reported outcomes one‐year post‐surgery
title_full_unstemmed Long head of biceps tendon augmentation in rotator cuff repair enhances tendon healing, shoulder function and patient‐reported outcomes one‐year post‐surgery
title_short Long head of biceps tendon augmentation in rotator cuff repair enhances tendon healing, shoulder function and patient‐reported outcomes one‐year post‐surgery
title_sort long head of biceps tendon augmentation in rotator cuff repair enhances tendon healing shoulder function and patient reported outcomes one year post surgery
topic cuff re‐rupture
long head of the biceps
rotator cuff repair
superior capsular reconstruction
url https://doi.org/10.1002/jeo2.70033
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