Abstract: [Objective] To analyze the clinical efficacy and safety of two different management methods of biceps longhead tendon in rotator cuff injury repair. [Methods] A retrospective analysis was performed on 72 patients with rotator cuff injury combined with rupture of the long head tendon of the biceps brachii in our hospital from January 2015 to March 2020. In the extrusion fixation group, interfacial screws were used to crush and fix the long head tendon of the biceps brachii during the repair of rotator cuff injury (37 cases). In the lasso fixation group, the long head tendon of biceps brachii was fixed with wire anchor during rotator cuff injury repair (35 cases). Observation indicators included perioperative conditions, follow-up indicators and imaging indicators, etc. [Results] The operation time and postoperative drainage volume in extrusion fixation group were significantly better than that in ligation fixation group (P<0.05). During follow-up, the functional scores of ASES in the squeeze fixation group were significantly better than those in the ligation fixation group (P<0.05), while there was no significant difference in VAS scores between the two groups (P>0.05). The incidence of adverse reactions in extrusion fixation group was significantly lower than that in ligation fixation group (P<0.05). There were no significant differences in imaging indexes between the two groups (P>0.05). [Conclusion] In the patients with rotator cuff injury combined with LHBT fracture who underwent arthroscopic rotator cuff repair, the interface screw extrusion fixation method to treat LHBT has better safety and better recovery of shoulder joint function, and has a certain effect in promoting wound healing and restoring functional exercise in the early stage. In addition, it can effectively reduce some perioperative indexes and minimize the adverse effects of iatrogenic injuries on shoulder functional recovery.