Does Concomitant Biceps Tenotomy Affect Shoulder Proprioception and Strength? - A Prospective Intra-Individual Comparison After Arthroscopic Rotator Cuff Repair

Sep 28, 2026

Long head of the biceps tendon pathology commonly accompanies rotator cuff tears, yet the impact of concurrent LHBT tenotomy during arthroscopic rotator cuff repair on postoperative shoulder proprioception and upper-limb strength remains uncertain. A prospective intra-individual comparison assessed adults undergoing arthroscopic RCR with LHBT tenotomy between May 2018 and December 2021. Outcomes included shoulder joint-position sense and maximum isometric strength. Among 77 patients, side-to-side differences in proprioception and strength were small with no clinically meaningful deficits, supporting acceptability of tenotomy when indicated.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Introduction

Material and Methods

Study Design and Setting

Results

Conclusions

CLINICAL RESEARCH e-ISSN 1643-3750 © Med Sci Monit, 2025; 31: e950383 DOI: 10. 12659/MSM.950383 Received: 2025.06.23 Accepted: 2025.09.23 Available online: 2025.10.20 Published: 2025.12.11 Authors’ Contribution: Study Design A Data Collection B Statistical Analysis C Data Interpretation D Manuscript Preparation E Literature Search F Funds Collection G ABDEF BCDEFF Corresponding Author: Financial support: Conflict of interest: 1 2 2 Does Concomitant Biceps Tenotomy Affect Shoulder Proprioception and Strength? A Prospective Intra‑Individual Comparison After Arthroscopic Rotator Cuff Repair Can Özcan Necip Güven Sehmuz Kaya Can Özcan, e-mail: [drcanozcan@gmail.com](drcanozcan@gmail.com) None declared None declared 1 Department of Orthopedics and Traumatology, Bursa Orhaneli State Hospital, Bursa, Türkiye 2 Department of Orthopedics and Traumatology, Faculty of Medicine, Van Yüzüncü Yıl University, Van, Türkiye Background: Pathology of the long head of the biceps tendon (LHBT) frequently accompanies rotator cuff tears. Whether concurrent LHBT tenotomy during arthroscopic rotator cuff repair (RCR) adversely affects postoperative shoulder proprioception or upper-limb strength remains uncertain; intra-individual evidence is limited. Material/Methods: A prospective intra-individual comparison was conducted at a single center between May 2018 and December 2021. Consecutive adults who underwent arthroscopic RCR with LHBT tenotomy were evaluated at a postoperative visit. Standardized assessments were performed by a single team. Primary outcomes included shoulder joint-position sense, measured by active position reproduction at predefined targets, and maximum isometric strength, measured with a handheld dynamometer. Statistical analysis included normality testing, paired tests, effect sizes, and 95% confidence intervals (CIs) with Holm adjustment. Results: Seventy-seven patients were analyzed (mean age 58.1 years; 73% women; 69% right side). Side-to-side differences were small. Representative metrics included elbow flexion D=-0.56 (95% CI, -1.05 to-0.06; P=0.028) and shoulder flexion D=-0.87 (95% CI, -1.41 to-0.33; P=0.002). Absolute proprioception error at 30° rotation was modestly lower on the operated side (D=-2.00°; 95% CI, -3.68° to-0.32°; P=0.020). Other targets showed no clinically meaningful differences. Effect sizes were small. Conclusions: In patients with clinical indications for tenotomy, concurrent LHBT tenotomy during arthroscopic RCR was unrelated to measurable deficits in shoulder proprioception or upper-limb strength. These findings support clinical acceptability of tenotomy when indicated. Comparative studies are warranted to refine patient selection. Keywords: Muscle Strength • Proprioception • Rotator Cuff • Shoulder Full-text PDF: [https://www.medscimonit.com/abstract/index/idArt/950383](https://www.medscimonit.com/abstract/index/idArt/950383) 3492 4 5 19 Publisher’s note: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher This work is licensed under Creative Common AttributionNonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) e950383-1 Indexed in: [Current Contents/Clinical Medicine] [SCI Expanded] [ISI Alerting System][ISI Journals Master List] [Index Medicus/MEDLINE] [EMBASE/Excerpta Medica][Chemical Abstracts/CAS] CLINICAL RESEARCH Özcan [C. et](C. et) al: No functional loss after biceps tenotomy © Med Sci Monit, 2025; 31: e950383 Introduction Rotator cuff tears are often accompanied by pathology of the long head of the biceps tendon (LHBT) [1]. Conditions such astenosynovitis, tendinopathy, partial rupture, or complete rupture of the

FAQs

What was the main research question of this study?

Whether concurrent long head of the biceps tendon (LHBT) tenotomy during arthroscopic rotator cuff repair affects postoperative shoulder proprioception or upper-limb strength.

How were shoulder proprioception and strength measured?

Shoulder joint-position sense was measured using active position reproduction at predefined targets, and maximum isometric strength was measured with a handheld dynamometer.

What did the study find about clinical outcomes after tenotomy?

In patients with clinical indications for tenotomy, concurrent LHBT tenotomy was unrelated to measurable deficits in shoulder proprioception or upper-limb strength, with only small and largely non-clinical side-to-side differences.

Sep 28, 2026

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