Flattening and/or anterior subluxation of the long head of the biceps tendon (LHB) is frequently seen in patients with a rotator cuff tear, which has been proposed by some surgeons to be the cause of shoulder pain. We evaluated the condition of the LHB in patients with a rotator cuff tear using a multi-reconstructed CTarthrography method. For the present study, we evaluated 24 shoulders in 23 patients who were diagnosed as having a rotator cuff tear, for which surgery was performed from May 2002 to September 2004. Patients with a complete tear of the LHB were excluded from this study. We carefully evaluated the condition of the LHB (LHB width, partial tear condition, and subluxation) during surgery and classified the patients into 3 groups, those without obvious pathological findings (Group N, n=10 shoulders), those with a flattened and/or partial tear of the LHB without subluxation (Group F, n=8 shoulders), and those with a subluxated LHB (Group S, n=6shoulders), based on our intraoperative findings. Oblique-sagittal reconstructed CT-arthrography images were used for the analyses. We defined percent length as the relative length between the joint surface margin and anterior edge of the LHB as the ratio of the length between the joint surface margin and the tip of the lesser tuberosity. The mean percent length in Group S was significantly greater than in the groups without an LHB subluxation. Further, there was a significant correlation between percent length and width of the LHB. The mean percent length in Groups N, F, and S was 16.5%,32.8%, and 79.0%, respectively, which were significantly different. We found that the results for percent length using reconstructed CT-arthrography images were related to intraoperative findings for the LHB, which showed that the present method is useful for preoperative evaluation of the LHB condition
