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Chronic rupture of the long head of the biceps tendon: comparison of 2-year results following primary versus revision open subpectoral biceps tenodesis

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript



The purpose of this study was to evaluate the clinical results of surgical repair for proximal long head of the biceps (LHB) tendon ruptures comparing chronic primary and postsurgical revision LHB tendon ruptures.

Materials and methods

Patients who underwent subpectoral LHB tenodesis for chronic ruptures with a minimum of 2 years from surgery were identified. ASES and SF-12 PCS scores and surgical and demographic data were collected prospectively. At final follow-up, patients were interviewed regarding symptoms related to their biceps. Symptoms were converted into a Subjective Proximal Biceps Score (SPBS).


Twenty-seven patients (22 males, 5 females) with a mean age of 61 years (range 40–76 years) underwent LHB tenodeses. Twenty patients (74.1 %) were primary repairs for chronic ruptures and seven patients (25.9 %) were revision repairs after failed prior LHB tenodesis. Twenty-five patients (92.6 %; n = 18 primary; n = 7 revision) were available for follow-up a mean of 3.8 years (range 2–6.1). The overall median postoperative SPBS showed significant improvement over the preoperative baseline (p < 0.001). Individual components of the SPBS showed substantial improvements. The SPBS significantly correlated with the postoperative ASES score (r = −0.478; p = 0.038). There were no differences in postoperative SPBSs between the primary and revision tenodesis groups. The mean postoperative ASES score was 90.3 and SF-12 PCS was 52.6.


Open subpectoral LHB tenodesis was a safe and effective method for the treatment of chronic LHB tendon ruptures and for the revision of failed post-surgical LHB ruptures. Patients had less pain, cramping, and deformity after LHB tenodesis. The SPBS, ASES, and SF-12 PCS scores significantly improved among this group of patients.

Level of evidence

Level III; Retrospective comparative study.

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Correspondence to Simon A. Euler.

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Conflict of interest

This research was supported by the Steadman Philippon Research Institute. The Institute receives research support from the following entities: Smith and Nephew Endoscopy, Inc.; Arthrex, Inc.; Siemens Medical Solutions USA, Inc.; Ossur Americas, Inc.; Opedix, Inc. This work was not supported directly by outside funding or grants. Peter J. Millett has received from Arthrex something of value (exceeding the equivalent of US$500) not related to this manuscript or research. He is a consultant and receives payments from Arthrex and has stock options in GameReady and Vumedi. He is also a consultant for Myos. Dr. Simon Euler had his research position at the Steadman Philippon Research institute funded by Arthrex. The other authors receive support from the Steadman Philippon Research Institute.

Additional information

The study was performed at the Steadman Philippon Research Institute, Vail, CO.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Video 1: This surgical video demonstrates a case of a revision subpectoral LHB tenodesis for symptomatic chronic LHB rupture following failed primary tenodesis using an interference screw. The rupture occurred six weeks prior to this intervention. (MP4 45261 kb)

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Euler, S.A., Horan, M.P., Ellman, M.B. et al. Chronic rupture of the long head of the biceps tendon: comparison of 2-year results following primary versus revision open subpectoral biceps tenodesis. Arch Orthop Trauma Surg 136, 657–663 (2016).

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