Evaluation of biceps brachii short head changes in preoperative and postoperative magnetic resonance imaging of patients undergoing biceps brachii long head tenotomy in shoulder arthroscopy

In rotator cuff lesions, pathologies of the long head tendon of the biceps muscle may accompany. The tendon of the long head of the biceps muscle is associated with many shoulder pathologies due to its close proximity to the rotator cuff muscles and its relationship with the superior glenoid labrum. It has been reported that 30-69% of cases with rotator cuff tears have pathology associated with the biceps long head tendon. Surgical treatment is recommended in tendon pathologies of the long head of the partial biceps muscle with severe pain. Tenotomy of the tendon of the long head of the biceps muscle is recommended for patients over 50 years of age and can be performed simply arthroscopically. Although problems such as cramping pain, limitation of elbow flexion, cosmetic deformity (Popeye's sign) and reduction in elbow flexion-supination strength are encountered, pain relief is observed. In patients who underwent tenotomy of the long head of the biceps brachi muscle in shoulder arthroscopy, it is expected that their pain will subside approximately in the 2nd postoperative month. However, in some cases, even in the 6th month postoperatively, it is seen that the pain does not regress despite the success of the operation. Although there are hypotheses and comments in the literature that the load on the short head increases when tenotomy is performed on the long head of the biceps; No study was found that included a detailed analysis of the changes in the short and long head of the biceps in preoperative and postoperative magnetic resonance imaging. In this study, we investigated the changes in the biceps short head in preoperative and postoperative MR imaging of patients who underwent tenotomy of the long head of the biceps in shoulder arthroscopy; We detected a significant increase in thickness both in the footprint of the biceps short head and 2 cm distal to the origin of the tendon at 6 months postoperatively, compared to the Wilcoxon signed-rang test. In this study, we radiologically demonstrated that the short head of the biceps becomes more functional after arthroscopic long head tenotomy for the biceps long head problems.