Incidence and Severity of Biceps Long Head Tendon Lesion in Patients with Complete Rotator Cuff Tears

Abstract

Background: Biceps long-head tendon lesion is commonly associated with rotator cuff tendon pathology. This study is to determine the pathologic spectrum of biceps long-head tendon in surgical cases with complete full-thickness rotator cuff tear. Methods: Between 1993 and 2002, 122 complete rotator cuff tears with surgery were included for the analysis. During surgery, biceps long-head tendon was grossly examined or evaluated via arthroscopy. A simplified classification was used to describe the biceps lesion. Results: Fifty patients (41%) had type 1 lesion (tendinitis), 10 (8%) had type 2 (subluxation), 12 (10%) had type 3 (dislocation), 15 (12%) had type 4 (partial tear), and 6 (5%) had type 5 (complete rupture). The remaining 29 patients (24%) did not have obvious pathology. All chronic (> 3 months) rotator cuff tears were associated with biceps tendon pathology. A rotator cuff tear greater than 5 cm2, as determined at surgery, was strongly associated with an advanced biceps lesion. Conclusion: Biceps tendon injuries are associated with complete rotator cuff tears, and there may be a causal relationship due to the impingement that occurs. Early identification and repair of rotator cuff lesions may prevent further deterioration of the biceps tendon.