Self-locking tenotomy of the long head of the biceps: What is the benefit?

Tenotomy and tenodesis of the biceps are the surgical techniques used to treat pathology of the long biceps. Between the proponents of the two techniques, the superiority of one over the other is still debated. The Popeye sign is often cited to the disadvantage of tenotomy. The aim of our study is to report on our experience using a self-locking tenotomy and its impact on Popeye's sign, and to assess our functional results. This is a retrospective study of 53 shoulders treated for long biceps tendinopathy, isolated or associated with a rotator cuff tear. All patients underwent surgery at the AILE 4 orthopedic department of the Ibn Rochd University Hospital in Casablanca over a period of five years, and were reviewed at least six months later. A self-locking tenotomy was performed in all patients. The mean age at surgery was 58 years. Popeye's sign was observed in five patients and was well accepted in four patients. Constant-Murray scores improved significantly by an average of 25 points. Satisfaction was over 90%. Professional and sporting activities were resumed in all patients. We highlight the value of the self-locking tenotomy as a simple, rapid, reproducible, effective and low-cost arthroscopic technique, ensuring a tenodesis effect by reducing the rate of appearance of Popeye's sign.