Purpose
The purpose of this study was to evaluate clinical outcomes and survivorship of isolated
biceps tenodesis (BT) at a minimum of 2 years and to identify patient-specific factors
associated with these outcomes in patients undergoing BT without concomitant rotator
cuff repair (RCR). We hypothesized that patient-reported outcomes would be significantly
improved on American Shoulder and Elbow Surgeons Survey (ASES) and Single Assessment
Numeric Evaluation (SANE), with a high rate of survivorship (>90%) at 2-year follow-up.
Methods
A retrospective review of an institutional registry was performed to identify patients
who underwent BT from July 2016 to December 2017. Patients >18 years old who underwent
an open or arthroscopic BT procedure using an interference screw, button, or anchor
for underlying bicipital pathology, without a concomitant RCR or shoulder arthroplasty,
and were a minimum of 2 years postoperative were included. Patients were administered
ASES and SANE questionnaires preoperatively and at final follow-up. Survivorship was
evaluated using Kaplan-Meier analysis. Failure was defined as any patient who underwent
reoperation related to the index surgery.
Results
A total of 110 patients (mean ± standard deviation age, 48.60 ± 12.14 years) who underwent
isolated BT with a follow-up of 24.90 ± 3.95 months were included in analysis. There
was a significant improvement in ASES and SANE at final follow-up (P < .001), with 81% to 84% of patients achieving minimal clinically important difference
(MCID), 72% to 82% achieving substantial clinical benefit (SCB), and 72% to 80% achieving
patient-acceptable symptom state (PASS). Worker’s Compensation (WC) patients had a
decreased likelihood of achieving PASS on ASES (P = .015) and SANE (P = .012). Four cases were deemed failures (3 revision BTs and 1 capsular debridement)
at 15.09 ± 9.57 months. WC did not have a significant effect on likelihood of BT failure.
Conclusion
Biceps tenodesis provided significant clinical improvement and high rates of survivorship
2 years postoperatively. WC was associated with a decreased likelihood of achieving
PASS. These results support the continued use of isolated BT for treating biceps pathology.
Level of Evidence
IV, case series.
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Article Info
Publication History
Published online: December 16, 2021
Accepted:
December 9,
2021
Received:
June 7,
2021
See commentary on page 1843Footnotes
The authors report the following potential conflicts of interest or sources of funding: A.B.Y. reports grants, Arthrex, Organogenesis, Vericel; personal fees, Conmed Linvatec, JRF Ortho, Olympus; other, PatientIQ, Smith & Nephew. B.F. reports other, Arthrex, Elsevier, Jace Medical, Smith & Nephew; personal fees, Stryker. B.J.C. reports nonfinancial support, International Cartilage Repair Society, American Journal of Orthopedics, American Journal of Sports Medicine, AANA, Journal of Shoulder and Elbow Surgery, Cartilage, Journal of the American Academy of Orthopaedic Surgeons; other, Arthrex, Smith & Nephew, Elsevier, Aesculap/B.Braun, Athletico, Bandgrip, JRF Ortho, National Institutes of Health (NIAMS and NICHD), Operative Techniques in Sports Medicine, Ossio, Regentis. K.C.P. reports other, DJ Orthopaedics. N.N.V. reports nonfinancial support, AOSSM, ASES, AANA, Knee, SLACK; other, Arthrex, Arthroscopy, Breg, Cymedica, Minivasive, Orthospace, Ossur, Smith & Nephew, Vindico Medical-Orthopedics Hyperguide, Wright Medical Technology. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
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© 2021 by the Arthroscopy Association of North America
