Biceps Tenotomy Does not Affect the Functional Outcomes of Patients Treated with Spacer Implantation Due to Massive Irreparable Rotator Cuff Tears

Eran Maman1, *, Ori Safran2, Shaul Beyth2, Gavriel Mozes3, Assaf Dekel3, Bernstein Michael4, Ofir Chechik1, Eliyahu Adar5
1 Shoulder Unit, Orthopedic Surgery Division Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
2 Orthopedic Surgery, Hadassah Medical Center, Jerusalem, Israel
3 Advanced Orthopedic Center, Assuta Medical Center, Tel Aviv, Israel
4 Yoseftal Hospital, Eilat, Israel
5 Department of Orthopedic Surgery, E. Wolfson Medical Center, Holon, Israel

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© 2017 Maman et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Shoulder Unit, Orthopedic Surgery Division Tel Aviv Medical Center, 6 Weizman Street, Tel Aviv 64239, Israel; Tel: +972-3-6973920; Fax: +972-3-6973065; E-mail:



Lesions of the long head of the biceps (LHB) tendon are frequently associated with massive rotator cuff tears (RCT) and may be responsible for shoulder pain and disability.


This study aimed to evaluate functional outcomes of arthroscopic biodegradable spacer implantation with or without biceps tenotomy as treatment for persistent shoulder dysfunction and pain due to a massive irreparable RCT.


A total of 48 patients were implanted with the subacromial spacer using arthroscopic approach with or without biceps tenotomy. All patients were assessed for up to 12 months post-implantation and 18 patients were assessed for at least 24 months (and a maximum of 40 months). Improvement in shoulder function was assessed using Constant score.


Subacromial spacer implantation was performed arthroscopically in 48 patients. The mean total Constant score increased from 36 at baseline to 67 points at 12 months post implantation. Patients who underwent LHB tenotomy in addition to the subacromial spacer presented similar improvement of their shoulder function and score compared to the group that was treated with the spacer alone.


Current study demonstrates that spacer implantation in this patient population provides significant improvement in function and decreases the pain. Additional LHB tenotomy did not influence the postoperative results during the follow-up.

Keywords: Biodegradable spacer, Massive rotator cuff tears, Biceps tenotomy, Pain, Shoulder function, Constant score.