Conversion of Failed Proximal Long Head of the Biceps Tenodesis to Distal Subpectoral Tenodesis: Outcomes in an Active Population

Peebles, Liam A.; Midtgaard, Kaare S.; Aman, Zachary S.; Douglass, Brenton W.; Nolte, Philip-Christian; Millett, Peter J.; Provencher, Matthew T.

doi:10.1016/j.arthro.2020.07.019

Cited by 6 publications

(3 citation statements)

References 31 publications

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“…12,13 However, an important consideration is that high-in-groove biceps tenodesis allows for revision to subpectoral tenodesis if failure of proximal tenodesis occurs. 1 Peebles et al 16 effectively documented this concept when evaluating the outcomes of an active military population (N ¼ 12) who underwent conversion of a failed proximal (suprapectoral) to distal (subpectoral) biceps tenodesis and found that all patients had a significant improvement in SANE and ASES scores, with no reported complications, and the ability to return to full active duty. To maximize pain relief and avoid the possibility of bicipital groove pain, subpectoral tenodesis can be performed with RCR; however, as this paper suggests, improvement in pain and functional outcomes can occur with more superior tenodesis locations.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Biceps Tenodesis Variations With Concomitant Rotator Cuff Repair: A Multicenter Database Analysis

Hagan

Hao

King

et al. 2023

Orthopaedic Journal of Sports Medicine

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Background: Studies to date comparing biceps tenodesis methods in the setting of concomitant rotator cuff repair (RCR) have demonstrated relatively equivalent pain and functional outcomes. Purpose: To compare biceps tenodesis constructs, locations, and techniques in patients who underwent RCR using a large multicenter database. Study Design: Cohort study; Level of evidence, 3. Methods: A global outcome database was queried for patients with medium- and large-sized tears who underwent biceps tenodesis with RCR between 2015 and 2021. Patients ≥18 years of age with a minimum follow-up of 1 year were included. The American Shoulder and Elbow Surgeons, Single Assessment Numeric Evaluation, visual analog scale for pain, and Veterans RAND 12-Item Health Survey (VR-12) scores were compared at 1 and 2 years of follow-up based on construct (anchor, screw, or suture), location (subpectoral, suprapectoral, or top of groove), and technique (inlay or onlay). Nonparametric hypothesis testing was used to compare continuous outcomes at each time point. The proportion of patients achieving the minimal clinically important difference (MCID) at the 1- and 2-year follow-ups were compared between groups using chi-square tests. Results: A total of 1903 unique shoulder entries were analyzed. Improvement in VR-12 Mental score favored anchor and suture fixations at 1 year of follow-up ( P = .042) and the onlay tenodesis technique at 2 years of follow-up ( P = .029). No additional tenodesis comparisons demonstrated statistical significance. The proportion of patients with improvement exceeding the MCID did not differ based on tenodesis methods for any outcome score assessed at the 1- or 2-year follow-up. Conclusion: Biceps tenodesis with concomitant RCR led to improved outcomes regardless of tenodesis fixation construct, location, or technique. A clear optimal tenodesis method with RCR remains to be determined. Surgeon preference and experience with various tenodesis methods as well as patient clinical presentation should continue to guide surgical decision-making.

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Section: Discussionmentioning

confidence: 99%

Outcomes of Biceps Tenodesis Variations With Concomitant Rotator Cuff Repair: A Multicenter Database Analysis

Hagan

Hao

King

et al. 2023

Orthopaedic Journal of Sports Medicine

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“…Several authors have demonstrated encouraging outcomes following revision biceps tenodesis after proximal failure leading to a Popeye deformity. 5 , 6 , 7 , 8 , 9 …”

Section: Introductionmentioning

confidence: 99%

Revision Open Subpectoral Biceps Tenodesis With Allograft Tendon Reconstruction for Symptomatic Failed Biceps Tenodesis

Galvin

Griswold

Steyn

et al. 2022

Arthroscopy Techniques

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“…While it is critical to evaluate the distinct biomechanical variables that adversely affect LHB tenodesis fixation strength, we cannot ignore the technical factors that can further influence adverse outcomes following this surgical procedure. Peebles et al 13 examines outcomes in patients with a failed proximal long head of the biceps tenodesis converted to distal subpectoral tenodesis using interference screws. All patients presented with favorable outcomes.…”

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confidence: 99%

Editorial Commentary: What Is More Important: Strength or Displacement? Findings of All-Suture Anchor Versus Interference Screw for Biceps Tenodesis

Provencher¹,

Peebles²

2021

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Tendinopathy of the long head of the biceps tendon (LHB) encompasses a range of pathology, including inflammatory tendinitis to degenerative tendinosis that can lead to pain, as well as instability of the LHB and its surrounding stabilizers. Accordingly, tenodesis of the LHB during shoulder surgery has been increasingly cited in the literature as a viable surgical option for the treatment of LHB pathology. While current treatment options include the use of multiple devices for tenodesis of the LHB, there remains a paucity of literature that investigates the biomechanical advantages of all-suture anchor devices compared to interference screws.

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Conversion of Failed Proximal Long Head of the Biceps Tenodesis to Distal Subpectoral Tenodesis: Outcomes in an Active Population

Cited by 6 publications

References 31 publications

Outcomes of Biceps Tenodesis Variations With Concomitant Rotator Cuff Repair: A Multicenter Database Analysis

Outcomes of Biceps Tenodesis Variations With Concomitant Rotator Cuff Repair: A Multicenter Database Analysis

Revision Open Subpectoral Biceps Tenodesis With Allograft Tendon Reconstruction for Symptomatic Failed Biceps Tenodesis

Editorial Commentary: What Is More Important: Strength or Displacement? Findings of All-Suture Anchor Versus Interference Screw for Biceps Tenodesis

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