title: Long-term functional results and isokinetic strength evaluation after arthroscopic tenotomy of the long head of biceps tendon.
abstract: BACKGROUND
  The objective of this study is to evaluate the biomechanical function of the upper arm after arthroscopic long head of biceps (LHB) tenotomy at long-term follow-up.
  
  
  METHODS
  Twenty-five male subjects ranging from 30 to 63 years old were evaluated at a mean follow-up of 7.0 years after tenotomy. Bilateral isokinetic testing was performed to obtain peak torque values, as well as total work done throughout the full range of elbow flexion and supination.
  
  
  RESULTS
  Magnetic resonance imaging scans revealed nine unrecognized LHB ruptures in the contralateral arm, leaving 16 subjects to complete the testing protocol. The mean quickDASH score was 8.1 (standard error [SE] 2.5). The mean oxford elbow score was 97.9 (SE 1.6). The tenotomy arm recorded a decrease in peak flexion torque of 7.0% (confidence interval [CI] 1.2-12.8), and a decrease in the peak supination torque of 9.1% (CI 1.8-16.4) relative to the contralateral arm. The total work carried out through the full range of joint motion was reduced in elbow flexion by 5.1% (CI -1.3-11.4) and in forearm supination by 5.7% (CI-2.4-13.9).
  
  
  CONCLUSIONS
  Maximum strength in elbow flexion and forearm supination is significantly reduced compared with the contralateral arm. However, this impairment is partially compensated for by relatively greater strength sustained through the latter stages of joint motion. This results in comparable total work measurements between the tenotomised and contralateral side, potentially accounting for ongoing high levels of patient satisfaction and clinical function in the long term after LHB tenotomy.
  
  
  METHODS
  Case series without comparison group.
authors.affiliation: Department of Orthopaedic Surgery, Sir Charles Gairdner Hospital, Perth, Australia.
authors.forename: Bertram
authors.initials: B
authors.lastname: The
authors.affiliation: School of Sport Science, Exercise and Health, University of Western Australia, Perth, Australia.
authors.forename: Mike
authors.initials: M
authors.lastname: Brutty
authors.affiliation: Department of Orthopaedic Surgery, Sir Charles Gairdner Hospital, Perth, Australia ; School of Sport Science, Exercise and Health, University of Western Australia, Perth, Australia ; Department of Orthopaedic Surgery, Saint John of God Hospitals, Perth, Australia.
authors.forename: Allan
authors.initials: A
authors.lastname: Wang
authors.affiliation: Department of Orthopaedic Surgery, Saint John of God Hospitals, Perth, Australia.
authors.forename: Peter T
authors.initials: PT
authors.lastname: Campbell
authors.affiliation: Department of Orthopaedic Surgery, Saint John of God Hospitals, Perth, Australia.
authors.forename: Michael J C
authors.initials: MJ
authors.lastname: Halliday
authors.affiliation: School of Sport Science, Exercise and Health, University of Western Australia, Perth, Australia.
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Ackland
keywords: Biceps tenotomy; isokinetic strength; long-term