Rotator cuff tear with concomitant long head of biceps tendon (LHBT) degeneration: what is the preferred choice? Open subpectoral versus arthroscopic intraarticular tenodesis

Abstract

Background Lesions associated with the biceps tendon are commonly detected during arthroscopic repair of rotator cuff tears. Acquiring a preferable technique to repair both cuff and long head of biceps tendon (LHBT) lesions was the aim of several recent studies. This study aimed to compare clinical and functional outcomes of open subpectoral versus arthroscopic intraarticular tenodesis in patients with repairable rotator cuff tear associated with LHBT degeneration. Patients and methods In this randomized clinical trial, 60 eligible candidates for arthroscopic rotator cuff repair (mean age 55.7 ± 6.9 years) were allocated to a control group (open subpectoral, SP) or intervention group (intraarticular, IA). In the IA group, an anchor suture was used for both rotator cuff repair and LHBT tenodesis. In the SP group, after arthroscopic repair of the rotator cuff, subpectoral tenodesis of LHBT was performed using an interference screw. Patients were evaluated for 2 years follow-up regarding pain intensity using the visual analogue scale (VAS) and shoulder function using the Constant Score and Simple Shoulder Test. Results The two groups were similar with regard to demographic characteristics and preoperative evaluations (all P > 0.05). The functional status of both groups was improved, but not significantly differently so between the two groups ( P = 0.1 and P = 0.4, respectively). Pain intensity decreased during the 2-year follow-up period, similarly so in the two groups. Patient satisfaction was also similar in the two groups. Conclusion Large and massive rotator cuff tears (tears > 3 cm) associated with LHBT pathologies benefited from intraarticular or subpectoral tenodesis similarly, with no differences in short- or mid-term results between these two techniques. Level of evidence II.

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

“…A total of 148 records were identified by the initial search. After selection, 9 RCTs [ 4 , 5 , 8 , 11 , 16 , 17 , 24 – 26 ] that met our inclusion criteria were included in this meta-analysis. The PRISMA flow diagram for the screening process in presented in Fig.…”

“…These non-RCTs usually have more potential sources of bias and confounding, as majority of surgeons prefer tenotomy for the elderly and tenodesis for younger patients, workers and athletes with higher levels of activity. [ 16 , 17 ] Therefore, findings came from these reviews were compromised by the limited availability of high-quality trials. To date, there is a lack of high-quality evidence, entirely from RCTs, to compare tenotomy and tenodesis for the treatment of LHBT lesions.…”

Clinical Outcomes of an All-Arthroscopic Biceps Tenodesis Using the Anterolateral Anchor During Concomitant Double-Row Rotator Cuff Repair

“…1,12,13,18,33 Although open techniques tended to have higher rates of morbidity, including nerve injury and wound complications, no study detected a clinically significant difference between the 2 techniques. 1,12,13,18,33 Duerr et al 10 reported an increase in ASES scores from 42.6 preoperatively to 91.0 postoperatively with their described arthroscopic suprapectoral biceps tenodesis. Our results are similar to these previous studies in that those patients undergoing our allarthroscopic technique had satisfactory clinical results with no complications at an average of 2 years of follow-up.…”

Staged arthroscopic procedure for treating simultaneous shoulder and elbow synovial chondromatosis: A case report and literature review

“…Tenodesis offers some theoretical advantages, including improved cosmesis, maintenance of elbow flexion power, pain relief, and muscle atrophy prevention. 19,21 Subacromial decompression, rather than acromioplasty, can provide significant benefits in terms of pain relief, particularly in lower demand patients, and preserve the coracoacromial ligament. 22 After early shoulder rehabilitation, we performed elbow arthroscopy for loose-body removal, followed by a synovectomy and debridement.…”