Arthroscopic proximal versus open subpectoral biceps tenodesis with arthroscopic repair of small- or medium-sized rotator cuff tears

Yi, Young; Lee, Jong-Myoung; Kwon, Seok Hyun; Kim, Jeong-Woo

doi:10.1007/s00167-015-3641-5

Cited by 37 publications

(53 citation statements)

References 32 publications

(37 reference statements)

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“…Arthroscopic proximal fixation and small incision-assisted distal fixation are common. In recent years, there have also been clinical studies on the comparison of the efficacy between distal and proximal fixation of the LHBT (15,16,(54)(55)(56)(57)(58), all of which suggested that the two methods have a good clinical efficacy, high patient satisfaction and few complications; no significant differences were observed in functional recovery, pain improvement and complications between the two methods. However, in the study by Duchman et al (15), a significant difference was observed in the shoulder flexion function between the two groups.…”

Section: Discussionmentioning

confidence: 99%

Small‑incision open distal subpectoral vs. arthroscopic proximal biceps tenodesis for biceps long head tendon lesions with repair of rotator cuff tears

Yang

Zhang

et al. 2019

Exp Ther Med

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The curative effect of small-incision open distal subpectoral vs. arthroscopic proximal biceps tenodesis for lesions in the long head of the biceps tendon (LHBT) combined with rotator cuff repairs (RCR) has remained controversial. The aim of the present study was to compare the two surgical methods. A total of 71 patients who received surgical treatment for LHBT lesions accompanied by RC tears were analyzed. Following arthroscopic RCR and tendectomy of the affected LHBT, 35 patients underwent small-incision open distal subpectoral tenodesis through a small incision (the subpectoral group), while the remaining 36 patients received arthroscopic proximal tenodesis (the arthroscopic group). The surgery time and intra-operative blood loss were compared between the two groups. In addition, the clinical outcomes were evaluated using scoring systems for the functional assessment of the shoulder joint. The subpectoral group had a shorter surgery time and less intra-operative blood loss than the arthroscopic group (P<0.05). The functional scores of the two groups significantly improved as time passed (P<0.05). The subpectoral group was significantly superior to the arthroscopic group with regard to the American Shoulder and Elbow Surgeons score at 2 weeks post-operatively and visual analog scale score at 2 weeks and 3 months post-operatively (P<0.05). Small-incision open distal subpectoral and arthroscopic proximal tenodesis were demonstrated to effectively improve the function of the shoulder joint and relieve pain caused by LHBT lesions accompanied by RCR. However, small-incision open distal subpectoral tenodesis had the additional advantage of shorter surgery time, less intra-operative bleeding and encouraging early results compared to arthroscopic proximal tenodesis. The study was registered as a clinical trial in the Chinese Trial Registry (no. ChiCTR1800015643).

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Section: Discussionmentioning

confidence: 99%

Small‑incision open distal subpectoral vs. arthroscopic proximal biceps tenodesis for biceps long head tendon lesions with repair of rotator cuff tears

Yang

Zhang

et al. 2019

Exp Ther Med

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“…We also assessed trends in concomitant procedures associated with rotator cuff repair surgery in Medicare patients, as 1 study suggested that the rates of these procedures have been increasing 31 despite there currently being a lack of evidence supporting their use. 1 , 17 , 22 , 29 , 33 …”

mentioning

confidence: 99%

Evaluation of the Trends, Concomitant Procedures, and Complications With Open and Arthroscopic Rotator Cuff Repairs in the Medicare Population

Jensen

Peter

Devana

et al. 2017

Orthopaedic Journal of Sports Medicine

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Background:Medicare insures the largest population of patients at risk for rotator cuff tears in the United States.Purpose:To evaluate the trends in incidence, concomitant procedures, and complications with open and arthroscopic rotator cuff repairs in Medicare patients.Study Design:Cohort study; Level of evidence, 3.Methods:All Medicare patients who had undergone open or arthroscopic rotator cuff repair from 2005 through 2011 were identified with a claims database. Annual incidence, concomitant procedures, and postoperative complications were compared between these 2 groups.Results:In total, 372,109 rotator cuff repairs were analyzed. The incidence of open repairs decreased (from 6.0 to 4.3 per 10,000 patients, P < .001) while the incidence of arthroscopic repairs increased (from 4.5 to 7.8 per 10,000 patients, P < .001) during the study period. Patients in the arthroscopic group were more likely to have undergone concomitant subacromial decompression than those in the open group (87% vs 35%, P < .001), and the annual incidence of concomitant biceps tenodesis increased for both groups (from 3.8% to 11% for open and 2.2% to 16% for arthroscopic, P < .001). While postoperative complications were infrequent, patients in the open group were more likely to be diagnosed with infection within 6 months (0.86% vs 0.37%, P < .001) but no more likely to undergo operative debridement (0.43% vs 0.26%, P = .08). Additionally, patients in the open group were more likely to undergo intervention for shoulder stiffness within 1 year (1.4% vs 1.1%, P = .01).Conclusion:In the Medicare population, arthroscopic rotator cuff repairs have increased in incidence and now represent the majority of rotator cuff repair surgery. Among concomitant procedures, subacromial decompression was most commonly performed despite evidence suggesting a lack of efficacy. Infections and stiffness were rare complications that were slightly but significantly more frequent in open rotator cuff repairs.

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“…There was a significant improvement (p<0.001) at follow-up for UCLA and Constant score, VAS for pain at rest and during motion, similarly in both groups, whereas ROM evaluation did not show significant improvement at the latest follow-up. Yi et al 23 reviewed 66 patients who underwent arthroscopic RC repair with arthroscopic proximal biceps tenodesis through a bioabsorbable interference screw (34 cases) or with open subpectoral tenodesis (32 cases). Within 3 months postoperatively, the VAS score significantly improved in the open subpectoral tenodesis group compared with the arthroscopic proximal tenodesis group (p<0.05), but no significant difference was found in the VAS score between the two groups after 6 months.…”

Section: Resultsmentioning

confidence: 99%

“…In the study by Jeong et al ,19 a comparable improvement in Constant and UCLA scores was found for both treatment groups, and slightly better flexion of the shoulder was achieved in the patients managed arthroscopically. Yi et al 23 found a significant difference in VAS for pain at short-term follow-up (2 weeks and 3 months), whereas the difference at 6 months became not significant, both for ASES and Constant scores. Given the lack of significant data on the topic, from a clinical point of view and from a case-management perspective, a few consideration must be taken into account.…”

Section: Discussionmentioning

confidence: 96%

No difference between tenotomy vs tenodesis for the long head of the biceps tendinopathy in rotator cuff repair: a systematic review

et al. 2017

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Arthroscopic proximal versus open subpectoral biceps tenodesis with arthroscopic repair of small- or medium-sized rotator cuff tears

Abstract: III.

Cited by 37 publications

References 32 publications

Small‑incision open distal subpectoral vs. arthroscopic proximal biceps tenodesis for biceps long head tendon lesions with repair of rotator cuff tears

Small‑incision open distal subpectoral vs. arthroscopic proximal biceps tenodesis for biceps long head tendon lesions with repair of rotator cuff tears

Evaluation of the Trends, Concomitant Procedures, and Complications With Open and Arthroscopic Rotator Cuff Repairs in the Medicare Population

No difference between tenotomy vs tenodesis for the long head of the biceps tendinopathy in rotator cuff repair: a systematic review

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