Abstract

The debate over the effectiveness of biceps tenotomy versus tenodesis in the management of long head of the biceps brachii (LHB) tendon lesions remains ongoing. This study aims to compare the clinical outcomes and patient satisfaction of these two procedures. Sixty-one patients (16 males and 45 females) were included in the study. Biceps tenodesis was performed on 32 patients, while biceps tenotomy was performed on 29. Statistical analyses were carried out using Statistical Package for the Social Sciences (SPSS) version 29.0, with descriptive statistics, repeated measures analysis of variance (ANOVA), Chi-Square tests, and independent t-tests utilized to compare the outcomes between the groups over a 12-month period. Patients who underwent tenotomy were generally older than those who had tenodesis (p=0.003). There were no significant differences between the groups in terms of body mass index (BMI), follow-up duration, or dominant hand distribution. Both groups demonstrated significant improvements in Visual Analog Scale (VAS), Constant, American Shoulder and Elbow Surgeons Scores (ASES), and range of motion (ROM) over time. However, the tenotomy patients had a higher incidence of cosmetic deformity (Popeye sign) and experienced earlier pain relief. Biceps tenodesis provides superior cosmetic outcomes but requires a longer recovery period. Biceps tenotomy offers faster pain relief but carries a higher risk of cosmetic deformity. The choice between the two procedures should be tailored to the patient's specific factors and preferences.

Key words: Biceps, tendon, tenotomy, tenodesis, shoulder