Biceps Tenodesis: An Evolution of Treatment (original) (raw)
Related papers
Trends in long head biceps tenodesis
The American journal of sports medicine, 2015
Tenodesis of the long head of the biceps tendon has become a popular surgical treatment option for patients with pain or instability attributed to a diseased or unstable biceps tendon. No previous studies have characterized the practice patterns of surgeons performing biceps tenodesis in the United States. To investigate current trends in both arthroscopic and open biceps tenodesis across time, sex, age, and region of the United States as well as associated charges. Descriptive epidemiology study. Patients who underwent biceps tenodesis (Current Procedural Terminology [CPT] codes 23430 and 29828) for the years 2008 through 2011 were identified using the PearlDiver Patient Record Database, including both private-payer and Medicare data. These cohorts were then assessed for associated diagnoses using International Classification of Diseases, 9th Revision, codes and concomitant procedures using CPT codes. These searches yielded procedural volumes, sex and age distribution, regional vol...
Arthroscopy, Sports Medicine, and Rehabilitation, 2021
The purpose of this meta-analysis was to provide an up-to-date comparison of clinical outcomes of tenotomy and tenodesis in the surgical treatment of long head of the biceps brachii (LHB) tendinopathy. Methods: A literature search was conducted in EMBASE, Pubmed/Medline and the Cochrane database from January 2000 to May 2020. All studies comparing clinical outcomes between LHB tenotomy and tenodesis were included. Quality was assessed using the Coleman score. Results: We included 25 studies (8 randomized studies) comprising 2,191 patients undergoing LHB tenotomy or tenodesis, with or without concomitant shoulder procedures (mainly rotator cuff repairs). The Coleman score ranged from 29 to 97 for all studies. When comparing tenodesis and tenotomy in randomized studies, no clinically relevant differences were found in the Constant score (mean difference, 0.9 points), the American Shoulder and Elbow Society Score (mean difference, 1.1 points), shoulder pain (mean difference in visual analogue scale,-0.3 points), elbow flexion strength loss (mean difference, 0%), or forearm supination strength (mean difference, 3%). A Popeye deformity (odds ratio, 0.32) was less commonly seen in patients treated with tenodesis (9% vs 23%). Conclusion: In our metaanalysis, a Popeye deformity was more frequently observed in patients treated with tenotomy. Based on a substantial number of studies, there is no evidence-based benefit of LHB tenodesis over tenotomy in terms of shoulder function, shoulder pain or biceps-related strength. It is unclear whether LHB tenodesis is of benefit in specific patient groups such as younger individuals. Level of evidence: Level III, systematic review of level III or higher studies.
Shoulder & Elbow, 2020
ObjectiveTo compare tenotomy versus tenodesis for the treatment of long head of the biceps tendon pathologies. The primary outcome was the shoulder functional outcome. The secondary outcomes consisted of postoperative pain, elbow flexion and forearm supination strengths and postoperative complications.MethodsPubMed, MEDLINE, Google Scholar and Web of Science were searched until April 2020. Included studies were randomized controlled trials with a minimum 12 months’ follow-up.ResultsBoth treatments had similar improvement on the Constant–Murley score at 6 months and 12 months. However, tenotomy had a significantly lower Constant–Murley score at two years with a mean difference of −1.13 (95% confidence interval −1.9, −0.35). Furthermore, tenotomy had a risk ratio of 2.46 (95% confidence interval 1.66, 3.64) for developing Popeye’s deformity. No significant difference was detected in other functional outcomes, pain, or elbow flexion and forearm strength indices.DiscussionTenodesis and tenotomy are both well-established techniques that similarly yield satisfactory outcomes. Despite that tenodesis had a statistically significant better Constant–Murley score at two years, this was clinically irrelevant. With the current evidence, we recommend either technique for the management of the long head of the biceps tendon pathologies.Level of evidenceTherapeutic, Level II
International Orthopaedics
Purpose Studies have shown that isolated tenotomy of the long head of the biceps (LHB) improves significantly pain scores, active range of motion and Constant score in elderly patients with massive and irreparable cuff tears with no osteoarthritis. This cadaveric study was performed to assess the feasibility of a tenotomy of the LHB and subacromial corticosteroid injection using a minimally invasive in-office setting under local anaesthesia on awake patients. Materials and methods Twenty scare-free shoulders were included in the study. We performed the procedure in an in-office setting using a wrist arthroscope with no fluid, connected to wireless camera and light source. A standard shoulder arthroscopy was finally performed in order to analyse the tenotomy quality and detect possible iatrogenic lesions. Results The LHB tendon was cut fully in all cases, the mean length of the proximal stump of the LHB was 0.4 cm (range, 0.3-0.7 mm) and the mean duration of the surgery was 3.5 minutes (range, 2.43-3.86 min). No iatrogenic lesion occurred during the in-office procedure. Conclusion This cadaveric study suggests that it is feasible and safe to perform, under local anaesthesia, a minimally invasive arthroscopic tenotomy of the LHB and subacromial injection using an in-office setting. Further clinical studies are needed to confirm the reliability, indication and effectiveness of this technique.
Tenodesis is not superior to tenotomy in the treatment of the long head of biceps tendon lesions
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2017
To compare the effectiveness of tenodesis and tenotomy in the treatment of long head of the biceps tendon (LHBT) lesions. The null hypothesis was that there is no difference in functional scores between the tenotomy and tenodesis groups. A total of 69 patients with a combined supraspinatus tear and LHBT lesion aged over 40 years entered this prospective comparative study and were randomly assigned to the arthroscopic LHB tenotomy or tenodesis group. Fifty-five patients (31 in the tenotomy group and 24 in the tenodesis group) were available for the 6- and 24-month post-operative evaluations. There were no statistically significant differences in post-operative Constant and Murley score, quality of life, pain, and strengths between groups. Higher rates of Popeye's sign were noted 6 and 24 months post-operatively in the tenotomy group compared to tenodesis. Although tenotomy is affected by a higher incidence of cosmetic deformity, there is no superiority of arthroscopic tenodesis o...
Biceps Tenotomy Vs Tenodesis in Patients Younger Than 50, Systematic Review
International Journal for Research in Applied Science & Engineering Technology (IJRASET), 2021
Purpose: The objective of this meta-analysis was to offer an up-to-date comparison of clinical outcomes of tenotomy and tenodesis in the surgical treatment of LHB tendinopathy in patients under the age of 50. Methods: A literature search was conducted in EMBASE, PubMed/Medline and the Cochrane database from January 2010 to Dec 2020. All studies that compared the clinical results of LHB tenotomy and tenodesis were included. Results: The Meta-analysis data were from nine studies that comprised 669 participants who had LHB tenotomy or tenodesis with or without other shoulder surgeries (mainly rotator cuff repairs). There were no clinically significant changes in the Constant score, the American Shoulder and Elbow Society Score, shoulder pain, elbow flexion strength loss, or forearm supination strength when tenodesis and tenotomy were compared in randomized studies. Patients who have tenodesis were less likely to develop a Popeye deformity. Conclusion: In a meta-analysis, patients who had a tenotomy were more likely to have a Popeye deformity. There is no evidencebased benefit of LHB tenodesis over tenotomy in terms of shoulder function, shoulder discomfort, or biceps-related strength, according to a large number of studies. It's unknown whether LHB tenodesis is beneficial to some patient populations, such as children.
The American journal of sports medicine, 2014
While a vast body of literature exists describing biceps tenodesis techniques and evaluating the biomechanical aspects of tenodesis locations or various implants, little literature presents useful clinical outcomes to guide surgeons in their decision to perform a particular method of tenodesis. To compare the clinical outcomes of open subpectoral biceps tenodesis (OSPBT) and arthroscopic suprapectoral biceps tenodesis (ASPBT). Our null hypothesis was that both methods would yield satisfactory results with regard to shoulder and biceps function, postoperative shoulder scores, pain relief, and complications. Cohort study; Level of evidence, 3. Patients who underwent either ASPBT or OSPBT for isolated superior labrum or long head of the biceps lesions with a minimum follow-up of 2 years were evaluated with several validated clinical outcome measures and physical examinations including range of motion and strength. Between 2007 and 2011, a total of 82 patients met all inclusion and excl...
BMC musculoskeletal disorders, 2017
Long head biceps tendon pathology is a common cause of anterior shoulder pain and is often associated with other shoulder conditions, such as rotator cuff tears and osteoarthritis. It is well accepted that older patients are at increased risk for major and minor peri- and postoperative complications. The purpose of this study is to investigate patients over 65 years old who underwent subpectoral biceps tenodesis and compare the complication rates of this group to those of patients younger than 65 years old. The hypothesis is, that there would be no difference in complication rates and that clinical outcome scores for patients over 65 were satisfying and showed improvements over time. There were 337 patients who underwent open subpectoral biceps tenodesis, between January 2005 and June 2015, 23 were identified as being over the age of 65 with a minimum follow up of 12 months. All patients over the age of 65 were evaluated pre- and postoperatively using Simple Shoulder Test (SST), Ame...