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

Malavolta, Eduardo Angeli; Sousa, Alana Caselato de; Gracitelli, Mauro Emílio Conforto; Assunção, Jorge Henrique; Silva, Fernando Brandão de Andrade e; Neto, Arnaldo Amado Ferreira

doi:10.1590/1516-3180.2021.0219.r1.28062021

Cited by 4 publications

(1 citation statement)

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“…Surgical interventions for LHBT tendinopathy include tenotomy and tenodesis [ 13 , 21 , 28 ]. Although both tenotomy and tenodesis lead to comparable clinical outcomes [ 1 , 21 , 22 , 24 ], there is a trend that patients prefer tenodesis to tenotomy owing to concerns regarding Popeye deformity [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Modified arthroscopic intra-articular transtendinous looped biceps tenodesis leads to satisfactory functional outcomes and less frequent Popeye deformity compared to biceps tenotomy

Chiang

Lin

et al. 2023

J Orthop Surg Res

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Purpose The present study aimed to propose a modified intra-articular transtendinous looped biceps tenodesis (mTLBT) using a suture anchor and to compare the functional outcomes and incidence of Popeye deformities between biceps tenotomy and mTLBT. Methods Medical records of patients who underwent either tenotomy or mTLBT for the long head of the biceps tendon (LHBT) lesion between January 2016 and April 2021 were retrospectively reviewed. The inclusion criteria were patients aged 40–70 years with LHBT pathologies, such as superior labrum anterior to posterior (SLAP) lesions > type II, LHBT pulley system rupture with bicipital instability, and intra-articular LHBT tear. The exclusion criteria were full-thickness supraspinatus tears, frozen shoulder, shoulder fracture, and postoperative traumatic events that affected the operated shoulder. All patients were followed up for at least 1 year. Popeye deformity, bicipital cramping pain, visual analog scale (VAS) pain score, and functional outcome scores (University of California at Los Angeles [UCLA] and American Shoulder and Elbow Surgeons [ASES] scores) were recorded. Fisher’s exact test and Chi-square test were used for categorical variables, whereas the Mann–Whitney U test was used for nonparametric variables. Results The mTLBT and tenotomy groups included 15 and 40 patients, respectively. The incidence of Popeye deformity and biceps cramping pain in the tenotomy group (52.5% and 50%, respectively) was significantly higher than that in the mTLBT group (13.3% and 20%, respectively) (p = 0.009 and p = 0.045, respectively). The postoperative VAS, UCLA, and ASES scores were not significantly different between the two groups. One patient in the tenodesis group experienced metallic-anchor pullout. Conclusion mTLBT is an arthroscopic intra-articular top of the groove tenodesis that can be performed completely in the intra-articular space and is especially suitable for patients with an intact or partially torn rotator cuff. This technique is reliable for treating biceps pathologies as it results in similar functional outcome scores, lesser biceps cramping pain, and less frequent Popeye deformity compared to biceps tenotomy. Level of Evidence III.

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