Incidence and severity of biceps long head tendon lesion in patients with complete rotator cuff tears

Background: Biceps long head tendon lesion is commonly associated with rotator cuff tendon pathology. This study is to determine the pathologic spectrum of biceps long head tendon in surgical cases with complete full thickness rotator cuff tear. Methods: Between 1993 and 2002, 122 complete rotator cuff tears with surgery were included for the analysis. During surgery, biceps long head tendon was grossly examined or evaluated via arthroscopy. A simplified classification was used to describe the biceps lesion. Results: 50 (41%) patients had type 1 lesion (tendinitis), 10 (8%) patients had type 2 lesion (subluxation), 12 (10%) patients had type 3 (dislocation), 15 (12%) patients had type 4 (partial tear), and 6 patients (5%) had type 5 (complete rupture). The remaining 29 patients (24%) did not have obvious pathology. All chronic rotator cuff tear (> 3 months) were associated with biceps tendon pathology. A rotator cuff tear greater than 5 cm² as determined at surgery was strongly associated with an advanced biceps lesion. Conclusion: Biceps tendon injuries are associated with complete rotator cuff tears and there may be a causal relationship due to the impingement that occurs. Early identification and repair of rotator cuff lesions may prevent further deterioration of the biceps tendon.