We evaluated patients at very long term with rupture of the long head biceps tendon (LHBT) in whom the tendon stump had been sutured to the coracoid tip (Gilcreest technique). Our aim was to determine the natural history of shoulders deprived of the LHBT and to assess the validity of the surgical technique. Between 1969 and 1981, 30 patients with rupture of the LHBT and no evidence of cuff tear underwent the Gilcreest operation. The mean age of the patients was 32 years (range, 20-49). Six of them were professional gymnasts. The 28 patients that could be traced were evaluated a mean of 31 years after operation. The mean Constant score (CS) was 74 in the entire group, and 86 in 22. The latter patients complained occasionally of mild shoulder pain. The remaining six patients had a mean CS of 56 (range, 40-81). Of the six, four (aged 66-71 years) had clinical and MR evidence of rotator cuff tear. The other two had undergone arthroscopic cuff repair (CS, 75-81). After operation, all professional gymnasts had returned to sport activity and all the other patients had resumed their jobs. After 30 years, the majority of the patients who had undergone the Gilcreest operation had good functional and cosmetic outcomes. Only a few patients had a cuff tear. The role of the LHBT as depressor of the humeral head is probably less important than generally believed.
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