Biceps tenodesis versus tenotomy in isolated LHB lesions: a prospective randomized clinical trial

Hufeland, Martin; Wicke, Sabrina; Verde, Pablo Emilio; Krauspe, Rüdiger; Patzer, Thilo

doi:10.1007/s00402-019-03136-4

Cited by 42 publications

(80 citation statements)

References 31 publications

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“…Our results show that very high patient satisfaction can be achieved with either tenotomy or tenodesis to address proximal biceps pathology. Recent literature is consistent with this finding, as many studies have found no significant differences in pain, function, or limitations between tenotomy and patients with tenodesis [6,16,[20][21][22][23][24]. However, others have shown increased shoulder pain and loss of supination power with biceps tenotomy, with many authors favoring biceps tenodesis in younger patients with a higher work and activity level [8,20,23].…”

Section: Discussionsupporting

confidence: 61%

“…Nord et al found that biceps shape was preserved in 90% of patients with tenotomy [15]. A small randomized prospective study similarly found no difference between tenotomy and tenodesis procedures for popeye sign or strength differences [16]. Overall, complication rates for tenodesis and tenotomy are relatively low, with most patients reporting positive outcomes [17][18][19].…”

Section: Introductionmentioning

confidence: 99%

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Biceps tenotomy versus tenodesis: patient-reported outcomes and satisfaction

et al. 2020

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Background: Biceps tenotomy and tenodesis are surgical treatments for pathology of the proximal tendon of the long head of the biceps. There is debate over which procedure provides better patient outcomes.Purpose: Compare patient-reported outcomes and satisfaction between biceps tenotomy and tenodesis. Methods: This retrospective cohort study including all patients undergoing arthroscopic biceps tenodesis or tenotomy as part of more extensive shoulder surgery with a single surgeon. Concomitant procedures included rotator cuff repair, subacromial decompression, acromioclavicular joint resection, and debridement. Patients 36-81 years old were contacted by phone at > 2-year post-operatively to complete a biceps-specific outcome questionnaire. Subject decision not to participate was the sole exclusion criterion. Satisfaction scores and frequencies of potential biceps-related downsides (biceps cramping/spasms, biceps pain, shoulder pain, weakness, cosmetic deformity) were analyzed for the effects of procedure, sex, and age.Results: Satisfaction score distributions were similar between patients with tenodesis and patients with tenotomy (χ 2 = 8.34, P = 0.08), although slightly more patients with tenodesis than patients with tenotomy reported being satisfied or very satisfied (96% versus 91%). Perceived downsides occurred more frequently among patients with tenotomy than in patients with tenodesis: 59% of patients with tenotomy reported ≥ 1 downside, versus 37% of patients with tenodesis (P < 0.01). In patients reporting ≥ 1 downside, distributions of total downsides differed between procedures (χ 2 = 10.04, P = 0.04): patients with tenotomy were more likely to report multiple concurrent downsides than were patients with tenodesis (31% versus 16%). Each individual downside tended to be reported as present by a greater proportion of patients with tenotomy than patients with tenodesis. Sex had no effect on satisfaction or downsides, but there was a trend for older patients to report higher satisfaction and fewer downsides.Conclusions: Biceps tenotomy and tenodesis are both viable treatments for proximal biceps tendon pathology, yielding high patient satisfaction. There were trends toward greater satisfaction and fewer problems in patients with tenodesis. Still, younger patients with tenodesis did report perceived downsides. Alternatively, older patients tended to be more satisfied with both procedures overall. Regardless of procedure, most patients receiving either tenotomy or tenodesis would undergo their respective surgery again. Level of Evidence: Level III evidence, retrospective comparative cohort study

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Section: Discussionsupporting

confidence: 61%

Section: Introductionmentioning

confidence: 99%

Biceps tenotomy versus tenodesis: patient-reported outcomes and satisfaction

et al. 2020

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“…Tenotomy of the LHBT may result in reduced force in elbow flexion and supination, the popeye-sign deformity, and painful cramps in the biceps. However, Hufeland et al 17 concluded in their prospective randomized study that there were no significant differences in terms of elbow flexion and forearm supination force between LHB tenodesis and tenotomy. Their findings additionally showed a nonsignificant trend toward a higher rate of popeye-sign deformities after biceps tenotomy.…”

Section: Discussionmentioning

confidence: 97%

“…Their findings additionally showed a nonsignificant trend toward a higher rate of popeye-sign deformities after biceps tenotomy. 17 The outcomes of tenotomy and tenodesis are still controversial, and further studies are required. We believe this technique could bring promising clinical outcomes with fewer complications; however, more studies with a larger patient population are required to fully assess the efficacy of this technique.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Rotator Cuff Repair Combined With Modified Superior Capsule Reconstruction as Reinforcement by the Long Head of the Biceps

Chiang

Shaw

Chih

et al. 2019

Arthroscopy Techniques

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In large or massive rotator cuff tears, successful repairs are difficult and complication rates are high, because the torn tendon is contracted and the superior capsule is disrupted. Recent studies have shown that superior capsule reconstruction (SCR) in massive irreparable rotator cuff tears results in better clinical scores and preserves stable glenohumeral stability without significant complications. In this article, we propose a simple, efficient SCR technique to reinforce the repair of large or massive rotator cuff tears. For this technique, the long head of the biceps tendon is used as a local autograft for the SCR, therefore eliminating comorbidities related to graft harvesting. The proximal part of the long head of the biceps tendon is transposed posteriorly and fixed onto the footprint as the SCR, which not only can maintain the stability of the glenohumeral joint, but also can preserve the vascular supply to help healing.

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“…This technique can be used to perform a closer anatomical reconstruction without destroying the residual upper joint capsule and the deep layer of the rotator cuff. Some scholars reported that the preliminary results of this technique are satisfactory, and the clinical efficacy and clinical score have been improved [7].…”

Section: Introductionmentioning

confidence: 99%

Application Strategy of Staged Nursing Intervention After the Surgery of Huge Rotator Cuff Tears Under the Arthroscopy

Zhang¹,

Xu²,

Lin³

et al. 2020

AJNS

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Objective: To explore the application of staged nursing intervention after the surgery of huge rotator cuff tear under the arthroscopy, and to evaluate the impact on patients' postoperative rehabilitation. Methods: A total of 25 patients who underwent arthroscopic surgery for large rotator cuff tears in our hospital from January 2018 to December 2019 were selected. The intervention group used a staged nursing program to intervene, and Selected 25 patients who only received routine nursing intervention during the same period as the control group. The constant-murley shoulder function score, UCLA score, SF-36 quality of life score, and nursing satisfaction score were compared between the two groups after 6 months. Results: There was no statistically significant in the difference in the scores of pain, functional activity, shoulder joint mobility, and muscle strength of the constant-murley shoulder function score between the observation group and the control group before surgery (P > 0.05). The pain, functional activities, shoulder joint mobility and muscle strength scores of the observation group were significantly higher than those of the control group 6 months after surgery (P < 0.05), and the UCLA score and SF-36 score of the observation group 6 months after surgery were significantly higher than the control group (P < 0.05), and the nursing satisfaction score of the observation group was significantly higher than that of the control group (P < 0.05). Conclusion: Staged nursing intervention can significantly improve the Shoulder joint functional rehabilitation process and quality of life of patients who post operation of huge rotator cuff tears, and improve nursing satisfaction.

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Biceps tenodesis versus tenotomy in isolated LHB lesions: a prospective randomized clinical trial

Cited by 42 publications

References 31 publications

Biceps tenotomy versus tenodesis: patient-reported outcomes and satisfaction

Biceps tenotomy versus tenodesis: patient-reported outcomes and satisfaction

Arthroscopic Rotator Cuff Repair Combined With Modified Superior Capsule Reconstruction as Reinforcement by the Long Head of the Biceps

Application Strategy of Staged Nursing Intervention After the Surgery of Huge Rotator Cuff Tears Under the Arthroscopy

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