# REINFORCEMENT WITH THE LONG HEAD OF THE BICEPS TENDON IN LARGE AND MASSIVE REPAIRABLE ROTATOR CUFF TEARS: A PROSPECTIVE CASE SERIES

**Authors:** GUSTAVO DE MELLO RIBEIRO PINTO, CRISTIANO NABUCO DANTAS, MARCELO COSTA DE OLIVEIRA CAMPOS, JORGE HENRIQUE ASSUNÇÃO, MAURO EMILIO CONFORTO GRACITELLI, EDUARDO ANGELI MALAVOLTA

PMC · DOI: 10.1590/1413-785220253302e288796 · 2025-10-13

## TL;DR

A study finds that using the biceps tendon to reinforce large rotator cuff repairs leads to improved function and low complications in patients.

## Contribution

This study introduces the use of the long head of the biceps tendon as reinforcement in large rotator cuff repairs with promising clinical outcomes.

## Key findings

- Pain and function scores improved significantly after surgery.
- The biceps healing rate was 84% with a 60% retear rate in the rotator cuff.
- No biceps-related complications or infections were observed.

## Abstract

The treatment of large and massive rotator cuff tears remains challenging. This study evaluates the efficacy and safety of reinforcement with the long head of the biceps tendon (LHBT) in patients with large and massive repairable rotator cuff tears.

This is a prospective case series involving 25 patients who underwent open repair of large and massive rotator cuff tears with LHBT reinforcement. All patients were operated by the same surgeon and followed up for one year.

Pain scores (VAS: 6.6 ± 2.30 vs. 2.68 ± 2.73; p<0.001) and function scores (ASES: 36.86 ± 19.27 vs. 73.96 ± 23.73; p<0.001; UCLA: 13.04 ± 3.83 vs. 26.04 ± 7.39; p<0.001) improved significantly postoperatively compared to preoperatively. The biceps healing rate was 84%, while the rotator cuff retear rate was 60%. No complications related to the biceps or surgical site infections were documented.

Reinforcement with the long head of the biceps tendon in the repair of large and massive rotator cuff tears shows satisfactory clinical outcomes and a low complication rate. Level of Evidence: IV, Case Series.

## Full-text entities

- **Diseases:** HEAD (MESH:D005271), Pain (MESH:D010146), infections (MESH:D007239), ROTATOR CUFF TEARS (MESH:D000070636)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

4 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12517554/full.md

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Source: https://tomesphere.com/paper/PMC12517554