2025 ISAKOS Biennial Congress Paper
Massive and Irreparable Rotator Cuff Tears Treated by Arthroscopic Partial Repair With Long Head of the Biceps Tendon Augmentation Provides Better Healing and Functional Results Than Partial Repair Only: Results From a Prospective Comparative Study
Hubert J. Laprus, MD, PhD, Cracow POLAND
Roman Brzóska, MD, PhD, Bielsko-Biala POLAND
Bartłomiej Krzysztof Juszczak, MD, Kraków, Małopolska POLAND
Grzegorz Słota, MD, PhD, Wilkowice POLAND
Aleksander Łapaj, MD,, Bielsko-Biala POLAND
Przemyslaw Lubiatowski, MD, Poznan POLAND
St Luke's Hospital, Bielsko-Biala, Slaskie, POLAND
FDA Status Not Applicable
Summary
Massive and irreparable rotator cuff tears reconstruction with additional long head of the biceps augmentation is clinically and radiologically superior than partial repair only
Abstract
Background
The aim of this study was to compare clinical and radiological outcomes of two treatment methods of massive and irreparable rotator cuff tears: partial repair (PR) and PR with long head of the biceps tendon augmentation (PRLHBTA).
Methods
This prospective, comparative study (Identifier: NCT05001581)
included 71 patients with massive and irreparable rotator cuff tears who underwent the surgery between 2016 and 2021. Other inclusion criteria were as follow: failure of non-operative treatment, patients with at least 1 year of follow-up, patients with Goutallier classification ≥ 3, and patients with Patte classification stage 3. In instances where there was an absence of intraoperative indicators of biceps tendon fraying or erosion, augmentation procedures were executed.
The clinical assessment protocol involved measurements of range of motion (ROM), shoulder strength, Constant-Murley Score (CMS), VAS Pain and SST Scores. Radiological assessment consisted of measurements of the Acromio-Humeral Index (AHI), the Hamada classification, the Sugaya’s classification and the Goutallier classification for both SSP and ISP.
Results
The study included data from 71 patients (38 in PRLHBTA and 33 in PR group) with a mean age of 63.6±8.1 years and a mean follow-up of 32±11.7 months. The retear rate was significantly higher for PR than for PRLHBTA group, respectively 75.8% vs 39.5% (p=0.002).
At the final examination statistically significant differences in favour of PRLHBTA were observed in both radiological: Sugaya’s classification 3.4±1.1 vs 4.1±0.8 (p=0.004), AHI 6.1±1.9 vs 4.8±1.3 [mm] (p=0.001) and Hamada classification 2.0±0.8 vs 2.6±0.8 (p=0.003), and clinical scales : VAS Pain Score 2.00±1.0 vs 2.61±1.2 (p=0.027), CMS 78.34±11.1 vs 71.36±11.2 (p=0.010). There were no significant differences in patients’ postoperative shoulder ROM, shoulder strength, Simple Shoulder Test (SST) and postoperative Goutallier scale.
Conclusion
PRLHBTA provides lower retear rate as well as superior clinical and radiological outcomes compared to PR in patients with irreparable and massive rotator cuff tears. The long of the biceps tendon promotes the healing of the rotator cuff repair construct and remains worth considering as an augmentation in cases with no intraoperative signs of tendon degeneration