Rotator cuff tear surgery, although intellectually interesting, does not seem to demonstrate a statistically significant clinical difference. Biceps tenotomy and tenodesis are are often performed concomitantly with rotator cuff repair or as separate procedures and can be a sole or concomitant cause of shoulder pain. Tenodesis, which may be performed as an arthroscopic or open procedure, generally restores pain free motion it the biceps tendon, or attached portion of the labrum, is the cause of the pain. Tenotomy is a shorter surgery, requiring less rehabilitation, that doctors tend to recommended for older patients who don't mind the cosmetic 'popeye sign' that sometimes is
Rotator cuff tear single physical examination test distinguishes reliably between bursitis, partial-thickness, and full-thickness tears. On the contrary, a combination of tests seems to provide the most accurate diagnosis. For impingement, these tests include the Hawkins-Kennedy impingement sign in which the examiner medially rotates the patient's flexed arm, forcing the supraspinatus tendon against the coracoacromial ligament and so producing pain if the test is positive a positive painful arc sign, and weakness in external rotation with the arm at the side. For the diagnosis of full-thickness rotator cuff tear, the best combination appears to include once more the painful arc and weakness in