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Tabrizian P, Nakhaei Amroodi M, Khajeh Alizadeh Attar M, Bahaeddini M, Mahdavifar M. Clinical Outcomes of Massive Rotator Cuff Tear Repair With Concomitant Biceps Tenodesis: A 13-year Retrospective Study. JROS 2026; 13 (3) :119-126
URL: http://jros.iums.ac.ir/article-1-2327-en.html

Background: Massive rotator cuff tears are challenging to treat and often result in significant pain and functional impairment. Rotator cuff repair combined with biceps tenodesis may improve shoulder function and pain relief, but long-term clinical outcomes and complication rates require further evaluation.
Objectives: This study aimed to evaluate the clinical outcomes of rotator cuff repair with concomitant biceps tenodesis in patients with massive rotator cuff tears, focusing on shoulder function, pain, muscle strength, postoperative analgesic use, reoperation rates, and complications.
Methods: This retrospective observational study included 54 patients (25 men and 29 women; mean age, 62.7 years) who underwent rotator cuff repair with concomitant biceps tenodesis between 2011 and 2024 at a tertiary referral center. Demographic characteristics, tear characteristics, and follow-up duration (mean, 32.9 months) were obtained from medical records. Outcome measures included the Constant–Murley score (CMS), visual analog scale (VAS) pain score, manual muscle testing (MMT), analgesic use at 3 months postoperatively, reoperation rate, and postoperative complications, including infection and thromboembolic events. Statistical analyses were performed using SPSS software, version 27.
Results: The mean postoperative CMS was 76.1±17.9, and 74% of patients achieved excellent or good outcomes. The median VAS pain score was 1 (interquartile range, 0–2). Muscle strength was better preserved in internal rotation (median MMT=5) than in external rotation and Jobe tests (median MMT=4). At 3 months postoperatively, 42.6% of the patients required analgesics and had significantly higher pain scores than those who did not (P<0.001). The overall reoperation rate was 14.8%, including 3.7% who underwent revision rotator cuff repair and 11.1% who required conversion to shoulder arthroplasty. One patient (1.9%) developed a postoperative infection, and no thromboembolic events were observed. A strong negative correlation was found between VAS and CMS (ρ=−0.71, P<0.001), indicating that lower pain levels were associated with better shoulder function.
Conclusion: Rotator cuff repair combined with biceps tenodesis is a safe and effective treatment for massive rotator cuff tears, providing substantial improvements in shoulder function and pain relief with acceptable complication and reoperation rates. These findings support its use as a reliable surgical option for managing complex rotator cuff pathologies.