Clinical outcomes of revision biceps tenodesis

Abstract

Purpose:Biceps tenotomy and tenodesis are effective treatment options for biceps pathology, but outcomes of revision surgery are not known. This study examines the clinical outcomes of patients who have undergone a revision biceps tenodesis.Materials and Methods:A retrospective review of all patients since 2004 (N = 21) who had undergone a revision biceps tenodesis with greater than 6-month follow-up was completed. A follow-up survey was carried out, and the visual analog scale (VAS), Single Assessment Numeric Evaluation (SANE), Simple Shoulder Test (SST), American Shoulder and Elbow Surgeons (ASES), and University of California – Los Angeles (UCLA) scores were obtained, along with SF-12 Mental (MCS-12) and Physical Component Summaries (PCS-12).Results:Indications for revision surgery were continued pain (14) and ruptured biceps (7). Complete follow-up examinations were performed in 15 of 21 patients (71.4%). Average follow-up was 33.4 ± 23.5 months. The mean postoperative scores were 1.9 out of 10, VAS; 79 out of 100, SANE; 10.2 out of 12, SST; 83 out of 100, ASES; 29 out of 35, UCLA; 44, PCS- 12; and 47.1, MCS- 12. Five patients were considered failures with a UCLA score below 27. Seventeen of twenty-one patient underwent concomitant procedures. Complete preoperative and postoperative data were collected for 14 patients. All scores demonstrated highly significant improvement from preoperative levels (P < 0.005), except for the MCS-12. There was no statistically significant difference in the outcomes of revision due to rupture and revision due to persistent pain.Conclusions:The results suggest that revision subpectoral biceps tenodesis provides significant pain relief and improvement in functional outcomes at a mean follow-up of 33.4 months.Level of Evidence:Case Series, Level 4.

Establishing minimum clinically important difference values for the Patient-Reported Outcomes Measurement Information System Physical Function, hip disability and osteoarthritis outcome score for joint reconstruction, and knee injury and osteoarthritis outcome score for joint reconstruction in orthopaedics

“…For this study, these visits were organized into four follow-up periods based upon the first recorded score within the database (baseline initial assessment): (1) 3-mo follow-up (80 to 100 d after initial assessment); (2) > 3-mo follow-up (90 d or more after initial assessment); 6-mo follow-up (170 to 190 d after initial assessment); and (3) > 6-mo follow-up (180 d or more after initial assessment). These follow-up periods were selected based upon recommendations within the literature[ 27 - 37 ]. It should be noted that the baseline score may not necessarily correlate with a specific intervention.…”

Evaluating instrument responsiveness in joint function: The HOOS JR, the KOOS JR, and the PROMIS PF CAT

“…Follow‐up time‐periods of 3‐ and 6‐month were selected to correspond with commonly used follow‐up periods in prior orthopaedic literature and clinical practice . Three‐ and six‐months and beyond follow‐up periods were used in addition to these narrowly defined time‐periods to broaden the catchment time‐frame to include the full‐range of patients seeking follow‐up care, also seen in prior literature . Paired sample t ‐tests evaluated the hypothesis that no change occurred between baseline and each follow‐up time point.…”

“…[39][40][41][42][43] Three-and six-months and beyond follow-up periods were used in addition to these narrowly defined time-periods to broaden the catchment time-frame to include the full-range of patients seeking follow-up care, also seen in prior literature. [44][45][46] Paired sample t-tests evaluated the hypothesis that no change occurred between baseline and each follow-up time point. The significance level was set at 0.05, two sided.…”

Suprapectoral biceps tenodesis: A biomechanical comparison of a new “soft anchor” tenodesis technique versus interference screw biceps tendon fixation

“…In fact, high rates of good to excellent clinical outcomes have been reported following surgical treatment using the IS fixation technique with small occurrence of fixation failure (Mazzocca et al, 2008;Nho et al, 2010). However, some complications have been reported after tenodesis with IS such as persistent bicipital pain or even bone fracture (Gregory et al, 2012;Mazzocca et al, 2008;Sears et al, 2011). Moreover, in open surgery, neurovascular injury or infection (Ma et al, 2009;Nho et al, 2010) has been reported.…”