Background: This retrospective cohort study was done to assess shoulder and elbow functions after rotator cuff tear operations and find the best method to manage accompanying biceps lesions. Methods: Fifty-four shoulders of 52 with range of age between 28-64years old. Participants in this study were classified into two groups: one received treatment through biceps tendon tenotomy, while the other underwent tenodesis. Regular clinical and radiological assessments were conducted to monitor their progress over time. The study aimed to compare the outcomes and complications experienced by both groups. Results: There was no noteworthy difference between the two groups concerning function and pain scores. The tenotomy group showed a ominously higher rate of Popeye deformity and the tenodesis group showed prolonged postoperative rehabilitation time. Conclusion: Shoulder complaints are improved after treating the biceps tendon thru repair of rotator cuff. Tenotomy and tenodesis are reliable methods to treat long biceps tendon lesions. We would recommend tenotomy for patients above 55 years old and inactive patients. Tenodesis is recommended to athletes, patients under 55 years old, and females, who would worry about cosmetic deformity.

Level of evidence: retrospective cohort, level of evidence (IV)