Open subpectoral biceps tenodesis in patients over 65 does not result in an increased rate of complications

Abstract

Background: Long head biceps tendon pathology is a common cause of anterior shoulder pain and is often associated with other shoulder conditions, such as rotator cuff tears and osteoarthritis. It is well accepted that older patients are at increased risk for major and minor peri-and postoperative complications. The purpose of this study is to investigate patients over 65 years old who underwent subpectoral biceps tenodesis and compare the complication rates of this group to those of patients younger than 65 years old. The hypothesis is, that there would be no difference in complication rates and that clinical outcome scores for patients over 65 were satisfying and showed improvements over time. Methods: There were 337 patients who underwent open subpectoral biceps tenodesis, between January 2005 and June 2015, 23 were identified as being over the age of 65 with a minimum follow up of 12 months. All patients over the age of 65 were evaluated pre-and postoperatively using Simple Shoulder Test (SST), American Shoulder and Elbow Surgeons (ASES), Constant-Murley (CM) and Single Assessment Numeric Evaluation (SANE). Intraoperative and postoperative adverse events (fracture, infection, wound opening, rupture/failure and neurovascular injuries) related to the tenodesis procedure and to the surgery itself were collected from all 337 patients in a routine postoperative follow-up. Results: The under 65 group (range 27-64 years) at an average follow up (FU) of 30 months (range 12-91 months) showed a 5.4% (17 out of 314) post-operative complication rate related to the subpectoral tenodesis, whereas the group over 65 (range 65-77 years) at an average follow up of 33 months (range 12-79 months) showed an 8.7% (2 out of 23) complication rate. Conclusion: This study demonstrates that in patients over the age of 65, biceps tenodesis is a successful procedure when performed for biceps tendinopathy and concomitantly with other surgical procedures of the shoulder, and does not result in an increased rate of complications when compared to a group of patients under the age of 65.

Similar clinical outcomes of biceps tenodesis with various kinds of fixation techniques: a systematic review

“…The overall complication in the interference screw fixation with the tie over screw technique was 5.2% (21 of 408 patients) in five studies 10 29–32. The number of fixation complications in one study by Voss was not identified making the fixation complication 1.1% (33 of 94 patients)32 (tables 1 and 3).…”

“…Interference screw fixation with tie over screw technique had significant improvement of postoperative ASES Score in 4 studies of 4 studies that reported both preoperative and postoperative scores,29–32 CM score 1 of 1 study,32 VAS pain score 3 of 3 studies 29–31…”

“…One study reported a postoperative CM Score of 89.232 and three studies reported postoperative VAS pain scores ranging from 0.3 to 2.5 with a score improvement range of 1.6 to 5.7.…”

Rates and Risk Factors for Revision Open and Arthroscopic Proximal Biceps Tenodesis

“…To our knowledge, no other study has identified prognostic variables associated with biceps tenodesis complications or failures. The influence of age on the complication rate after biceps tenodesis was recently studied by Voss et al, 19 who found that patients older than 65 years did not have an increased risk of complications after biceps tenodesis. The present study supports this finding for both arthroscopic and open biceps tenodesis in older populations.…”

Incidence and Characteristics of Humeral Shaft Fractures After Subpectoral Biceps Tenodesis

“…Pathology of the long head of the biceps is a common source of anterior shoulder pain and is often associated with other intra-articular shoulder pathology. 23,25 Two established surgical treatment options are biceps tenotomy and tenodesis. These procedures can address a number of internal derangements associated with the long head of the biceps tendon, including tendinopathy and SLAP (superior labrum anterior to posterior) tears.…”