Factors associated with long head of the biceps tendon tear severity and predictive insights for grade II tears in rotator cuff surgery

Abstract

Background: In rotator cuff repair, the long head of the biceps tendon (LHB) is a common graft material. However, the factors associated with LHB tear severity are poorly understood, and predicting grade II LHB tears is difficult. This study aimed to identify those factors before surgery. Methods: The demographics, medical parameters, and pain severity of 750 patients who underwent arthroscopic surgery from January 2010 to February 2021 were evaluated to determine the factors associated with LHB tear severity and grade II LHB tears. Both the overall study population and the large-to-massive rotator cuff tear (RCT) cohorts were analyzed using ordinal and binary logistic regression analyses. Predictive accuracy for grade II LHB tears was determined using the area under the receiver operating characteristic curve (AUC) curve. Results: In the overall cohort, high-sensitivity C-reactive protein (hs-CRP) >1 mg/L, a subscapularis tear, hypothyroidism, and the tangent sign (P≤0.031) were significantly associated with LHB tear severity, and hs-CRP>1 mg/L, a subscapularis tear, and the Patte retraction degree were significantly associated with grade II LHB tears (P<0.001). In the large-to-massive RCT cohort, hs-CRP>1 mg/L, hypertension, and age ≥50 years (P≤0.034) were significantly associated with LHB tear severity, and hs-CRP>1 mg/L and hypertension were significantly associated with grade II LHB tears (P≤0.026). In both cohorts, hs-CRP >1 mg/L demonstrated good predictive accuracy for grade II LHB tears (AUCs: 0.72 and 0.70).Conclusions: Serum hs-CRP >1 mg/L is associated with LHB tear severity and serves as a reliable predictor of grade II LHB tears, facilitating preoperative assessment of the LHB as potential graft material in arthroscopic rotator cuff repair.Level of Evidence: Level III