AIM: Rotator cuff tears and long head of the biceps tendon (LHBT) injuries are primary causes of shoulder pain. During rotator cuff repair, concurrent LHBT injuries are frequently identified. Surgical management of LHBT injuries can effectively relieve pain and improve shoulder function. Two commonly used surgical approaches for LHBT repair are interference screw compression fixation and suture anchor ligation fixation. However, no definitive conclusion has been reached regarding which technique yields superior clinical outcomes. This study compared the efficacy of arthroscopic rotator cuff repair combined with different LHBT fixation techniques in treating repairable rotator cuff tears with LHBT injuries and evaluated their impact on shoulder joint function.

METHODS: This retrospective study analyzed clinical data from 112 patients with rotator cuff tears and LHBT injuries who underwent arthroscopic rotator cuff repair at the Department of Orthopedics of Xiaoshan Affiliated Hospital of Wenzhou Medical University. Patients were allocated into two groups based on the LHBT fixation method: interference screw tenodesis group (n = 54) and suture anchor tenodesis group (n = 58). Functional outcomes were evaluated using the Constant-Murley shoulder function score, University of California at Los Angeles (UCLA) shoulder score, and visual analogue scale (VAS) at preoperative baseline and at 3, 6, and 12 months postoperatively. The incidence of postoperative complications was also compared between the two groups.

RESULTS: In both the interference screw tenodesis group and the suture anchor tenodesis group, VAS scores at all postoperative time points were significantly lower than preoperative values, while Constant-Murley and UCLA scores were significantly higher than baseline (all p < 0.008). Both groups showed a progressive improvement over time (scores at 6 and 12 months were significantly better than at 3 months, and scores at 12 months were better than at 6 months; all p < 0.008). Between-group comparisons showed that VAS scores in the suture anchor tenodesis group at 3, 6, and 12 months post-operatively were significantly lower than those in the interference screw tenodesis group (p < 0.05). Additionally, the Constant-Murley scores and UCLA scores in the suture anchor tenodesis group at 3 and 6 months were significantly higher than those in the interference screw tenodesis group (p < 0.05). No statistically significant differences in Constant-Murley or UCLA scores were observed between the two groups at baseline or at 12 months postoperatively. The incidence of postoperative complications was slightly lower in the suture anchor tenodesis group compared with the interference screw tenodesis group; however, the difference did not reach statistical significance (p > 0.05).

CONCLUSIONS: For proximal LHBT injuries, both interference screw compression fixation and suture anchor ligation under shoulder arthroscopy can effectively restore LHBT continuity, relieve shoulder pain, and improve functional outcomes. Suture anchor ligation demonstrates superior efficacy in pain relief, particularly during early postoperative recovery. However, in terms of long-term functional improvement at 12 months, both techniques yield comparable results. Moreover, suture anchor fixation is associated with a relatively lower, although not statistically significant, rate of postoperative complications.