The Hitchcock procedure. A cause for failure: a case report.

A 40-year-old man with a tenodesis of the long head of the biceps brachii in the bicipital groove (Hitchcock's operation) for bicipital tendinitis had recurrence of pain seven months after the operation. Roentgenograms of the acromiohumeral interval, taken when the patient tensed the biceps brachii, showed significant upward migration of the humeral head with a decrease in the acromio-humeral interval on the operated side. The authors postulate that resection of the stabilizing, intraarticular segment of the long head of the biceps in the Hitchcock's procedure allowed the short head to draw the humeral head proximally, resulting in a decrease in the acromiohumeral interval and recurrence of impingement. This is one possible explanation for the poor long-term results of the Hitchcock procedure.