Patient Satisfaction After Biceps Tenotomy

Abstract

Background:Biceps tenotomy and tenodesis are frequently performed for proximal biceps lesions; however, there continues to be debate as to which method is superior. This study examined patient-reported outcomes after biceps tenotomy.Hypothesis:Biceps tenotomy in the setting of concomitant shoulder pathology is a reasonable option with high satisfaction rates and a low incidence of pain and cramping in middle-aged to older individuals.Study Design:Case series; Level of evidence, 4.Methods:A total of 104 patients (mean age, 63.5 years; range, 40-81 years) were evaluated at the time of surgery and at a mean follow-up of 38.4 months (range, 22-57 months). Biceps tenotomy was performed as a component of more extensive shoulder surgery in all patients. Patient satisfaction, frequency of cramping and spasms, biceps pain, weakness, and cosmetic deformity were evaluated at over 1-year follow-up.Results:Ninety-one percent of patients were satisfied or very satisfied with their surgical outcome, and 95% would have their surgery again. Three patients who reported being unsatisfied or very unsatisfied had either advanced glenohumeral arthritis or an irreparable rotator cuff tear. Cosmetic deformity occurred in 13% of patients. Twenty percent reported spasms and cramping in their biceps, and 19% reported some biceps pain; however, frequency of spasms and cramping was typically once weekly, and biceps pain was reported as severe or very severe in only 2 patients. Subjective biceps weakness was reported in 17% of patients. Age had no effect on outcome measures, and female sex was associated with less limitation and greater satisfaction after tenotomy compared with men.Conclusion:Our results indicate that patient-reported downsides to biceps tenotomy were usually mild and/or infrequent and did not affect patient satisfaction. We conclude that biceps tenotomy is a viable option that can lead to a high rate of patient satisfaction and outcomes in middle-aged to older individuals undergoing shoulder surgery with biceps pathology.

Biceps tenotomy versus tenodesis: patient-reported outcomes and satisfaction

“…Finally, the tendon was fixated with an interference screw (Arthrex Tenodesis screw, Naples, FL). Patients with tenotomy tended to be treated earlier in the study period (2009-2011), and their results were previously reported in Meeks et al [18]. The same data collection methods were used for patients with tenodesis later in the study period (2013)(2014)(2015) to allow direct comparison of cohorts [18].…”

“…This study is a continuation of the previously published "Patient Satisfaction After Biceps Tenotomy" by Meeks et al [18] All procedures were performed by a single surgeon, concomitantly with subacromial decompression, acromioclavicular joint resection, and/or debridement surgeries for other shoulder pathologies (Table 1). Patients underwent tenotomy or tenodesis for proximal biceps or superior labral complex pathology, with ultimate treatment based on patient factors and surgeon decision.…”

“…All answers, including whether a popeye deformity developed, were subjectively assessed by the patient themselves and, therefore, specifics (i.e., for biceps pain, delineation between groove versus muscle pain) were not distinguished. The survey, which has previously been published, focused on specific questions related to management of the biceps tendon [18]. Of 149 patients with tenodesis contacted, 111 consented to participate (75% response rate), 32 were lost to follow-up, and 6 declined to participate.…”

“…Mean age was 63.5 ± 8.6 years (range 40-81 years), and the cohort was 46% male/ 54% female. Mean follow-up time was 38.4 ± 5.8 months (range 22-57 months) ( Table 1) [18].…”

“…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].…”