Popeye sign: Tenodesis vs. self-locking "T" tenotomy of the long head of the biceps

Abstract

Introduction: Treatment of long head of the biceps lesions is controversial. A new technique of self-locking "T" tenotomy was developed in our department in 2013.

Hypothesis: The main objective of the present study was to assess onset of Popeye sign after "T" tenotomy, with comparison to long head of the biceps tenodesis.

Material and methods: A continuous retrospective study included 180 patients with long head of the biceps lesion, either isolated or associated with rotator cuff tear.

Results: 130 underwent "T" tenotomy (group A), and 50 tenodesis (group B). Mean age was 57.9 years (range, 23-88 years) in group A and 50.8 years (range, 20-66 years) in group B. At last follow-up, 27.7% of patients in group A and 24% in group B showed Popeye sign (P=0.616), after equivalence test and adjustment on age and occupational activity. Bicipital groove pain was more frequent in the tenodesis group (44% versus 25.4%; P=0.025).

Discussion: Self-locking "T" tenotomy did not significantly differ from tenodesis in onset of Popeye sign or clinical results, and showed better postoperative course.

Level of evidence: IV, retrospective study.

Keywords: Biceps lesion; Rotator cuff tear; Shoulder; Tenodesis; Tenotomy.