Editorial Commentary: In Situ Biceps Tenodesis Is Useful in the Treatment of Irreparable Rotator Cuff Tears

For irreparable posterior superior rotator cuff tears (IPSRCTs), techniques other than reverse shoulder arthroplasty and tendon transfer are still under research; among these, reusing the long head of the biceps (LHB) is noteworthy. Various techniques of LHB reuse have been reported and can be divided into 3 biomechanical categories: restoration of the force chain of the rotator cuff, augmentation of the superior capsule, and combined force-chain restoration and superior capsule augmentation, among which in situ biceps tenodesis may be the simplest. LHB reuse for IPSRCTs is always combined with partial rotator cuff repair, and clinical studies have revealed that this combined treatment is effective in most cases. However, the structural and functional conditions of IPSRCTs vary. For each LHB reuse method, the most suitable conditions for its use should be explored. Likewise, for each specific rotator cuff tear condition, the best method for LHB reuse also needs to be explored. Studies of high level of evidence and long-term follow-up are needed.