Clinical comparison of arthroscopic double-row rotator cuff repair with or without long head of biceps tendon transposition.

Background: Long head of biceps tendon (LHBT) transposition is a novel technique based on the double-row suture bridge method, utilizing autologous reconstruction to treat massive rotator cuff tears.

Aim: To evaluate the mid-to-long-term clinical outcomes following the double-row repair method for massive rotator cuff tears.

Methods: This retrospective analysis included data from 53 patients with massive rotator cuff tears treated at our hospital between 2020 and 2021. The patients were divided into the double-row repair group (conventional group) and the double-row repair combined with the LHBT transposition group (transposition group). Postoperative pain was assessed using the visual analogue scale at one week, one year, and the final follow-up. Shoulder function was evaluated using the American Shoulder and Elbow Surgeons and Constant-Murley scores at one year and the final follow-up. Rotator cuff healing was assessed postoperatively for one year using the Sugaya classification, which categorizes tendon integrity based on magnetic resonance imaging findings.

Results: No perioperative complications were observed in any of the patients at any time. There were no significant differences between the groups regarding operative time and intraoperative blood loss. The transposition group had significantly lower visual analogue scale scores than the conventional group at one week postoperatively; however, there were no significant differences between the groups at one year or the final follow-up. At one year postoperatively, the transposition group showed significantly higher American Shoulder and Elbow Surgeons and Constant-Murley scores than the conventional group; no significant differences were observed at the final follow-up. There were no significant differences in rotator cuff healing between the groups at one year postoperatively.

Conclusion: Compared to double-row repair alone, double-row repair combined with LHBT transposition for treating massive rotator cuff tears more effectively alleviates short-term postoperative pain and improves shoulder function within the first year.