Lesions of the Long Head of the Biceps Tendon Concomitant with Rotator Cuff Tears: Tenotomy or Subpectoral Mini‐open Tenodesis? A Comparative Short to Mid‐term Follow‐up Study

Abstract

ObjectiveTo compare the clinical and radiological outcomes of patients who underwent rotator cuff repair (RCR) concomitant with long head of the biceps tendon (LHBT) tenotomy or subpectoral mini‐open tenodesis.MethodsProspectively collected data was reviewed on 154 patients, who underwent a LHBT procedure (tenotomy or tenodesis) concomitant with RCR between January 2010 and January 2017. The exclusion criteria were irreparable massive rotator cuff tear, rotator cuff partial tear, subscapular tendon tear, glenohumeral arthritis, and prior shoulder surgery. The two patient groups are as follows: RCR + Tenotomy (Group A) and RCR + Subpectoral mini‐open tenodesis (Group B). The visual analog scale (VAS) for pain, Constant Score scale, American Shoulder and Elbow Surgeons (ASES) scores, and the Disabilities of the Arm, Shoulder and Hand (DASH) scores preoperatively and 1 month, 3 months, 6 months, 1 year postoperatively and the latest out‐patient clinic were compared between the two groups.ResultsNinety‐two patients in Group A and 62 patients in Group B completed the follow‐up, with a median follow‐up time of 27 and 42 months respectively. At the final follow‐up, the VAS, Constant, ASES, and DASH scores in Group A were 0.1 ± 0.2, 87.0 ± 12.8, 96.4 ± 4.3 and 6.6 ± 4.8 respectively, and the VAS, Constant, ASES, and DASH scores in Group B were 0.1 ± 0.3, 92.5 ± 3.9, 96.3 ± 3.6 and 2.9 ± 1.3 respectively. Clinical evaluation scales showed satisfactory results in both groups, and there were no statistically significant differences between the two groups at the same follow‐up time. Popeye sign was detected in one case of Group A (1.1%) and in one case of Group B (1.6%, P > 0.05).ConclusionBoth tenotomy and subpectoral mini‐open tenodesis are effective for concomitant lesions of the LHBT in patients with reparable rotator cuff tears, and subpectoral mini‐open tenodesis of the LHBT does not provide any significant clinical or functional improvement than isolated tenotomy.

Biceps tenotomy versus tenodesis for lesions of the long head of the biceps tendon

“…In addition, recent clinical studies also yield opposite results in terms of constant score. [ 24 , 34 ] In the current study, the pooled Constant scores are consistent with the studies by Na et al [ 14 ] and Shang et al [ 13 ] However, even though the result for Constant score was statistically reliable after sensitivity analysis, the TSA indicated that the meta-analysis may obtained false-positive conclusion. As shown in Fig.…”

Tenotomy or Tenodesis for Tendinopathy of the Long Head of the Biceps Brachii: An Updated Systematic Review and Meta-analysis

“…Twenty-five studies reporting on 2,191 participants were included in this meta-analysis. 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 Of these, 1,003 patients were treated with tenodesis (46%), and 1,188 were treated with tenotomy (54%). There were 8 level I studies, 5 level II studies and 12 level III studies.…”

Biceps tenotomy or tenodesis in association with rotator cuff repair: is there an influence on functional results? A retrospective cohort study

“…In addition, the surgical technique used was not standardized, and included different tenodesis sites and use of an anchor for the LHBT independently or in association with rotator cuff repair. Most comparative studies have evaluated tenodesis with anchors, 7 , 19 – 22 , 25 and few have evaluated use of interference screws. 17 , 24 …”