Biceps Tenotomy is Associated with Similar Clinical Results and Lower Complications than Subpectoral Tenodesis with Rotator Cuff Repair in Elderly Patients

Objective: The objective is to compare the clinical outcomes and complications of biceps tenotomy vs. subpectoral biceps tenodesis in elderly patients undergoing arthroscopic rotator cuff repair.Methods: This retrospective study analyzed 38 patients aged 65 who underwent arthroscopic supraspinatus repair between 2020 and 2022.Patients were divided into 2 groups: biceps tenotomy (n = 22) and subpectoral tenodesis (n = 16).Preoperative and postoperative functional outcomes were assessed using Constant and ASES (American Shoulder and Elbow Surgeons Score) scores.Complication rates, including humeral fractures and Popeye deformity, were documented.Statistical analysis was performed using independent t-tests and chi-square tests.Results: Both groups demonstrated significant postoperative improvements in Constant and ASES scores (P < .001).Tenotomy was associated with shorter operative time (81 12.2 vs. 94 18.2 minutes, P = .02).Two humeral fractures occurred in the tenodesis group, while none were observed in the tenotomy group.Popeye deformity was reported in 3 patients in the tenotomy group and none in the tenodesis group.Muscle cramping occurred more frequently in the tenotomy group (5 vs. 1).Despite these differences, functional outcomes and patient satisfaction were comparable between groups. Conclusion:Both biceps tenotomy and subpectoral tenodesis provide excellent functional outcomes in elderly patients undergoing rotator cuff repair.Tenotomy offers the advantages of shorter operative time and lower complication rates, making it a safer option for elderly patients with higher surgical risks.Surgical decisions should be individualized based on patient-specific factors.