Measurement of biceps tendon retraction after arthroscopic tenotomy.

BACKGROUND One of the treatment options for the long head of the biceps tendon (LHBT) pathology is tenotomy. To our knowledge, no study in the literature evaluates the degree of retraction after tenotomy. The goals of this study are to determine the distance of this retraction, and identify its relationship with patient characteristics. METHODS An observational prospective survey over 3 months was conducted among 30 patients, operated arthroscopically, between August 2018 and April 2019 by the same surgeon. A radiopaque device was introduced inside the long head of biceps tendon before tenotomy. X rays were done to evaluate the distance of retraction at day 1 (D-1), day 30 (D-30) and day (D-90). RESULTS Thirty patients were included, of whom 63.3% (19) were female. Ten patients (33.3%) were operated for rotator cuff tear (RCT), others (66.7%) were operated for sub acromial impingement who failed conservative management. The mean retraction of LHBT (distance between the glenoid and clip: D-GC) increases from 1.9cm (day 1) to 3.5cm (day 90). All three measures significantly increased from D-1 to D-90. According to student's T-test, the mean retraction in the sub-acromial impingement group was significantly higher when comparing to RCT at D-0, D-30 and D-90. BMI, younger age, sex and dominant hand did not show any relation with long head biceps retraction, (p>0.05). The mean retraction of LHBT was significantly higher at D-90 for patients presenting positive Popeye sign (-p-value <0.05). CONCLUSION At 3 months of follow-up, the mean LHBT retraction was 3.5 cm from the glenoid and 2.5 cm from the greater tuberosity. It dynamically increases from day 1 to day 90. It will retract and sit beyond the transverse humeral ligament in the bicipital groove (BG). The LHBT significantly retracts more when allowing early mobilization of the shoulder.