COMPARATIVE EFFECTIVENESS OF ARTHROSCOPIC LHBT TRANSPOSITION VERSUS COMPLETE REPAIR TECHNIQUES IN ATHLETES WITH MASSIVE ROTATOR CUFF TEARS

Abstract

Objective: This study aimed to evaluate the efficacy of arthroscopic long head of biceps tendon (LHBT) transposition repair versus complete repair (CR) for massive rotator cuff tears (mRCTs) in athletes, focusing on early clinical outcomes and recovery impact. Methods: A retrospective analysis was conducted on 45 mRCT patients, comparing those treated with arthroscopic LHBT transposition repair to those undergoing CR. Metrics compared included operative time, number of rivets used, intraoperative blood loss, postoperative drainage, length of hospital stay, preoperative and postoperative imaging data, visual analogue score (VAS), shoulder constant score (CS), University of California, Los Angeles Rating score (UCLA), and shoulder mobility metrics (anterior flexion, external rotation [ER], and internal rotation [IR]). Results: No early postoperative complications were noted in either group. Both groups exhibited significant immediate postoperative improvements in acromiohumeral distance (AHD), with higher AHD observed in the LHBT group at 6 months and 1 year postoperatively (P<0.05). Notably, the LHBT group showed a lower incidence of re-tears and better functional outcomes in shoulder mobility, VAS, UCLA, and CS at one year postoperatively and at final follow-up (P<0.05). Conclusion: Arthroscopic LHBT transposition repair appears to offer superior outcomes compared to CR in treating athletes with massive rotator cuff tears. It effectively enhances pain management, shoulder function, and increases subacromial space height, thereby reducing postoperative re-tear rates. These findings suggest that LHBT transposition repair could be particularly beneficial in a sports setting, aiding athletes in achieving faster and more effective recovery from significant shoulder injuries.