When people tear their rotator cuff—a group of muscles and tendons that help lift and rotate the arm—they often need surgery.
What the study showed about the best procedures for rotator cuff surgery
Sometimes, these patients also have injuries to another nearby tendon called the long head of the biceps tendon (LHBT). Doctors usually treat this tendon using one of two procedures: tenotomy or tenodesis.
A new clinical study looked at which of these two treatments better helps people regain strength in their arm after surgery. The focus was especially on elbow bending (flexion) and forearm rotation (supination)—two basic but important movements that are often affected by biceps problems.
Tenotomy is when the damaged biceps tendon is cut and left to retract. It’s a quicker and simpler surgery. Tenodesis, on the other hand, is a bit more complex—it involves cutting the tendon and then reattaching it to a different spot on the bone. This is done to try to preserve strength and prevent muscle deformity.
The study involved 60 patients who were all undergoing arthroscopic rotator cuff repair.
Half received tenotomy and the other half had tenodesis. Six months after surgery, the researchers tested their arm strength and muscle activity using special tools.
So what did the study find?
- When it came to supination strength—that is, rotating the forearm to turn the palm up—there was no major difference between the two groups.
- However, for elbow flexion strength—bending the elbow—patients who had tenodesis did better. They had greater muscle strength and higher muscle activity based on electromyographic (EMG) readings.
- The researchers noted that tenodesis preserved more muscle function in the biceps compared to tenotomy.
In simple terms, both surgeries helped, but tenodesis gave better results when it came to keeping arm strength, especially for elbow bending.
One of the study’s lead authors, Dr Andreas Mueller, PD, explained,:
“Our goal was to see which procedure offers patients the best chance at full recovery. We found that while both tenotomy and tenodesis are valid options, tenodesis shows better strength preservation in the early recovery period.”
This doesn’t mean tenotomy is a bad option. It’s still a common choice, especially for older or less active patients.
But for people who want to maintain muscle strength—like athletes or manual labourers—tenodesis might be the better choice.
As always, anyone facing this kind of surgery should talk to their surgeon about what’s best for them. This study gives helpful information to guide those decisions.
DISCLAIMER: This article is for informational purposes only and is based on findings from a specific clinical study. It is not intended to provide medical advice, diagnosis, or treatment recommendations. Always consult with a qualified healthcare professional before making any decisions about medical procedures, treatments, or surgery. Individual cases vary, and only a licensed medical expert can guide what’s appropriate for your specific condition.
