RESULTS. Three patients in the LB group and 4 patients in the EB group were lost to follow up, and these patients

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1 RESULTS Three patients in the LB group and 4 patients in the EB group were lost to follow up, and these patients were excluded from the analysis. Finally, 71 patients were included in the analysis (36 in the LB and 35 in the EB group) (Fig. 3). Fig. 3 Study flow diagram Demographics and surgical data are shown in Table 1. Biceps procedures were performed in 47 cases (tenotomy in 4 cases and subpectoral anchor tenodesis in 43 cases). Tear size was categorized according to amount of tendon involvement; tears confined to 1 tendon (supraspinatus) were observed in 12 cases, supraspinatus tears with some degree of infraspinatus involvement in 45 cases, and tears involving 2 or more tendons (the supraspinatus, infraspinatus, and part of the subscapularis) were observed in 14 cases (Table 1). TABLE 1. Patient Demographics and Surgical Data Variables

2 Age (years) 59.7 ± ± Sex (M/F) 17/19 20/ Laterality (Right/Left) 25/11 26/ Number of involved tendons (1 : 1.5 : 2)* 9 : 21 : 6 3 : 24 : Biceps procedure (no : tenotomy : subpectoral 14 : 3 : : 1 : tenodesis) Results are presented as means±sds or absolute numbers. F = female; M = male * 1 : 1.5 : 2 represent tears confined to 1 tendon (supraspinatus), supraspinatus tears with some degree of infraspinatus involvement, and tears involving 2 or more tendons (supraspinatus, infraspinatus and part of the subscapularis), respectively. Preoperative pain VAS scores were similar in the two study groups and no significant difference was observed during follow up (Table 2). TABLE 2. Pre- and postoperative VAS pain scores Preop VAS 4.8 ± ± PO 5 wk VAS 2.7 ± ± PO 3 mo VAS 3.5 ± ±

3 PO 6 mo VAS 2.2 ± ± PO 1 yr VAS 1.6 ± ± Data are presented as means ± SDs. Regarding postoperative ROMs, FF was similar in the two groups throughout follow up. The LB group showed significantly better ER at 6 mo and 1 yr postoperatively, and tended to show greater IR at the back at 6 mo postoperatively (Table 3). TABLE 3. Postoperative serial ROMs PO 3 mo Forward flexion ( ) 111 ± ± External rotation ( ) 20 ± ± Internal rotation (spine level reached) 14.5 ± ± PO 6 mo Forward flexion ( ) 139 ± ± External rotation ( ) 31 ± ± Internal rotation (spine level reached) 11.4 ± ± PO 1 yr VAS Forward flexion ( ) 154 ± ± External rotation ( ) 40 ± ± Internal rotation (spine level reached) 9.4 ± ± Data represent means ± SDs. As mentioned above, internal rotation was measured according to the vertebral level reached by the tip of

4 the thumb. At final follow up (1 year postoperatively), Constant scores, Simple Shoulder Test (SST) scores, and American Shoulder and Elbow Surgeons (ASES) scores were evaluated. However, no intergroup difference was observed (Table 4). TABLE 4. Functional scores of the two study groups Constant 76.6 ± ± Simple Shoulder Test 9.5 ± ± American Shoulder and Elbow Surgeons score 87.8 ± ± Data represent means ± SDs. At 5 weeks, 3, and 6 months after surgery, healing failures evaluated by sonography were not significantly different. Similarly, no significantly intergroup difference was found by MRI at 1 year after surgery (Table 5). TABLE 5. Healing of rotator cuff tendons PO 5 wk (healed vs unhealed) 35 vs 1 30 vs PO 3 mo (healed vs unhealed) 35 vs 1 27 vs PO 6 mo (healed vs unhealed) 32 vs 0 28 vs PO 1 yr (healed vs unhealed) 17 vs 3 18 vs Note that sonography was performed at 5 weeks, 3 months, and 6 months and MRI was performed at 1 year, postoperatively. PO = postoperative

5 Marked bursal thickening was more frequently observed in the EB group at 6 months after surgery, but at 1 year this difference had diminished. TABLE 6. Marked bursal thickening (> 2 mm) in the two groups at different times after surgery PO 5 wk (yes vs no) 21 vs vs PO 3 mo (yes vs no) 25 vs vs PO 6 mo (yes vs no) 18 vs vs PO 1 yr (yes vs no) 15 vs 5 17 vs Note that sonography was performed at 5 weeks, 3 months, and 6 months and MRI was performed at 1 year, postoperatively. PO = postoperative