Purpose
To compare patient-reported outcomes and healing rates after open subpectoral and
all-arthroscopic suprapectoral biceps tenodesis without the use of interference screws
in patients with more than 2 years of follow-up.
Methods
Patients with at least 2 years of follow-up who underwent open subpectoral biceps
tenodesis or all-arthroscopic suprapectoral biceps tenodesis without concomitant rotator
cuff repair, labral repair, or Mumford procedure were considered for enrollment in
the study. They were evaluated for visual analog scale (VAS), American Shoulder and
Elbow Surgeons (ASES) score, and satisfaction with function and biceps contour. Ultrasonography
was performed to evaluate the integrity of the tenodesis site and measure biceps muscle
diameters on each arm.
Results
Forty-nine patients were eligible for our study and of these, 38 were able to participate.
Twenty-three patients had open subpectoral biceps tenodesis and 15 received all-arthroscopic
suprapectoral biceps tenodesis. The average follow-up time was 4.5 years (range 2-9.1 years).
There were no significant differences in anterior shoulder pain VAS, ASES scores,
or satisfaction rates. The average anterior shoulder VAS was 0.7 ± 1.1 for the open
group and 0.9 ± 1.8 for the arthroscopic group (P = .74). The mean ASES score for the open group was 90.6 ± 11.4 and 91.4 ± 13.9 for
the arthroscopic group (P = .69). All patients had an intact tenodesis site on ultrasonography and the ratio
of operative to nonoperative biceps diameters was 100.2% ± 12.8% for the open group
and 99.1% ± 10.8% for the arthroscopic group (P = .66). There were no infections and no brachial plexus injuries in either group.
Conclusions
Open subpectoral biceps tenodesis and all-arthroscopic suprapectoral biceps tenodesis
are both successful surgeries with consistently positive outcomes. Tenodesis can be
performed in either location without interference screw fixation with durable, reliable
results.
Level of Evidence
Level III, retrospective comparative trial.
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References
- Biceps tendon and superior labrum injuries: Decision-making.J Bone Joint Surg Am. 2007; 89: 1844-1855
- Long head of the biceps tendinopathy: Diagnosis and management.J Am Acad Orthop Surg. 2010; 18: 645-656
- Tenotomy versus tenodesis in the management of pathologic lesions of the tendon of the long head of the biceps brachii.Am J Sports Med. 2009; 37: 828-833
- Biceps tenotomy versus tenodesis: A review of clinical outcomes and biomechanical results.J Shoulder Elbow Surg. 2011; 20: 326-332
- Anatomy, function, injuries, and treatment of the long head of the biceps brachii tendon.Arthroscopy. 2011; 27: 581-592
- Complications of proximal biceps tenotomy and tenodesis.Clin Sports Med. 2016; 35: 181-188
- The long head of biceps and associated tendinopathy.J Bone Joint Surg Br. 2007; 89: 1001-1009
- Trends in long head biceps tenodesis.Am J Sports Med. 2015; 43: 570-578
- Keyhole tenodesis of biceps origin at the shoulder.Clin Orthop Relat Res. 1975; 112: 245-249
- Subpectoral biceps tenodesis with interference screw fixation.Arthroscopy. 2005; 21: 896.e1-896.e7
- Biomechanical evaluation of open suture anchor fixation versus interference screw for biceps tenodesis.Orthopedics. 2011; 34: e275-e278
- Arthroscopic keyhole proximal biceps tenodesis: A technical note.J Orthop Surg (Hong Kong). 2011; 19: 379-383
- Arthroscopic biceps tenodesis: A new technique using bioabsorbable interference screw fixation.Arthroscopy. 2002; 18: 1002-1012
- Mechanical strength of four different biceps tenodesis techniques.Arthroscopy. 2005; 21: 992-998
- Biomechanical comparison of two techniques for arthroscopic suprapectoral biceps tenodesis: Interference screw versus implant-free intraosseous tendon fixation.J Shoulder Elbow Surg. 2014; 23: 1731-1739
- Shoulder arthroscopy: Surgical technique.Surg Technol Int. 1993; 2: 447-453
- Biceps tendon.in: Shoulder Arthroscopy. 3rd ed. Wolters Kluwer Health, Philadelphia, PA2015: 91-95
- Arthroscopic suprapectoral and open subpectoral biceps tenodesis: A comparison of minimum 2-year clinical outcomes.Am J Sports Med. 2014; 42: 2583-2590
- Suprapectoral mini-open biceps tenodesis—functional and sonographic results.Z Orthop Unfall. 2015; 153: 153-159
- All-arthroscopic suprapectoral versus open subpectoral tenodesis of the long head of the biceps brachii.Am J Sports Med. 2015; 43: 1077-1083
- Tenotomy or tenodesis for long head biceps lesions in shoulders with reparable rotator cuff tears: a prospective randomised trial.Knee Surg Sports Traumatol Arthrosc. 2015; 23: 464-469
- Clinical success of biceps tenodesis with and without release of the transverse humeral ligament.J Shoulder Elbow Surg. 2012; 21: 66-71
- Analysis of “hidden lesions” of the extra-articular biceps after subpectoral biceps tenodesis: The subpectoral portion as the optimal tenodesis site.Am J Sports Med. 2015; 43: 63-68
Article info
Publication history
Published online: September 19, 2016
Accepted:
July 14,
2016
Received:
April 20,
2016
Footnotes
See commentary on page 26
The authors report the following potential conflict of interest or source of funding: M.H.G. receives support from AANA Board of Directors, DePuy Synthes, and Wolters Kluwer. S.J.S. receives royalty for product development from Conmed, Arthrex, and djOrtho. J.P.B. receives support from Conmed and Mitek.
Identification
Copyright
© 2016 by the Arthroscopy Association of North America
