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Tenodesis is not superior to tenotomy in the treatment of the long head of biceps tendon lesions

  • Shoulder
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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope



To compare the effectiveness of tenodesis and tenotomy in the treatment of long head of the biceps tendon (LHBT) lesions. The null hypothesis was that there is no difference in functional scores between the tenotomy and tenodesis groups.


A total of 69 patients with a combined supraspinatus tear and LHBT lesion aged over 40 years entered this prospective comparative study and were randomly assigned to the arthroscopic LHB tenotomy or tenodesis group. Fifty-five patients (31 in the tenotomy group and 24 in the tenodesis group) were available for the 6- and 24-month post-operative evaluations.


There were no statistically significant differences in post-operative Constant and Murley score, quality of life, pain, and strengths between groups. Higher rates of Popeye’s sign were noted 6 and 24 months post-operatively in the tenotomy group compared to tenodesis.


Although tenotomy is affected by a higher incidence of cosmetic deformity, there is no superiority of arthroscopic tenodesis over tenotomy in the treatment of LHBT lesion as a concomitant procedure to an arthroscopic repair of the supraspinatus tendon in terms of functional outcomes, quality of life, pain, and strength measured 6 and 24 months post-operatively.

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Author information

Authors and Affiliations



RC conceived of the study and performed all surgeries. MDB and NO collected the data. FF, MDG, and DAR drafted the manuscript. MDG performed the statistical analysis. OG and GG conceived of the study and participated in its design and coordination and helped to draft the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Olimpio Galasso.

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Conflict of interest

The authors declare that they have no competing interests.


No fundings were received for this study.

Ethical approval

The study protocol was approved by the local ethical committee (Villa Maria Cecilia Hospital, no. 03/2012), and the research was performed in compliance with the Helsinki Declaration.

Informed consent

All the patients gave informed consent for participation in this study.

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Castricini, R., Familiari, F., De Gori, M. et al. Tenodesis is not superior to tenotomy in the treatment of the long head of biceps tendon lesions. Knee Surg Sports Traumatol Arthrosc 26, 169–175 (2018).

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