I can speak with pretty good authority on the topic. I’ve had a distal bicep repair done e on my left and the long head bicep repair/which is at the top on my right. The distal biceps rupture absolutely Has to be repaired. The long head which is a the top at the shoulder doesn’t necessarily need to be need to be repaired but it will have the Popeye deformity . My distal repair according to my doctor is stronger than before. I have put it under a tremendous amount of load since the surgery and all is well. My long head repair needed to be redone as I re- ruptured it during the healing process. Now I’m about 10 months out and it seems to be fine. To be clear , the long head repair was done during a shoulder surgery which they do a lot. Apparently the long head bicep anchor point is a major pain generator when it comes to shoulder pain. They unhooked it and lowered it outside the shoulder joint.