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Biceps Management During Rotator Cuff Tear: Confounding Variables Result in Unclear Indications.
Arthroscopy 2024 May 4
Is "killing the biceps" during rotator cuff repair a capital crime or a lawful act? One of the most passionately debated topics in shoulder surgery is what to do with the biceps during rotator cuff repair: save, tenotomize, or tenodese. Results of repair are not very successful, and as repair of massive rotator cuff tears shows a 40-57% failure rate, there is renewed interest in sparing the biceps tendon as a humeral head depressor, or so that it may be used as a local graft for revision rotator cuff repair. The literature regarding tenodesis versus biceps sparing during rotator cuff repair is controversial. There are so many confounding variables affecting rotator cuff repair outcomes (tear size, comorbidities, age, tissue quality, etc.), that we do not believe that anything less than a randomized, prospective, study that matches groups is likely to provide a conclusive verdict.
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