Low incidence of failure after proximal biceps tenodesis with unicortical suture button

Cook, Jay B.; Sedory, David M.; Freidl, Michael; Adams, Douglas R.

doi:10.1016/j.jor.2017.06.007

Cited by 17 publications

(8 citation statements)

References 24 publications

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“…Switching to the onlay technique was based on promising biomechanical and clinical data. 11,12 Additionally, the onlay technique is cost-effective, since it can be combined with an anchor used for rotator cuff repair, as opposed to using an additional separate anchor (interference screw) with the inlay technique.…”

Section: Methodsmentioning

confidence: 99%

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Arthroscopic Biceps Tenodesis Outcomes: A Comparison of Inlay and Onlay Techniques

Haidamous¹,

Noyes²,

Denard

2020

Am J Sports Med

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Background: Arthroscopic biceps tenodesis (ABT) high in the groove can be achieved using an inlay or an onlay technique. However, there is little information comparing outcomes between the 2. Purpose: To compare postoperative healing and functional outcomes of ABT high in the groove performed using either an onlay or an inlay technique. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective study was performed on patients undergoing ABT at the articular margin (high in the groove) at a single center over a 2-year period. An inlay technique using an interference screw was performed during the first year, followed by an onlay technique using a knotless suture anchor during the second. Tendon healing, elbow flexion strength, functional outcome, and complications were evaluated at a postoperative minimum of 1 year. Results: A total of 37 patients with inlay and 53 with onlay ABTs were available for follow-up. There was no difference in range of motion, functional outcome scores, or elbow flexion strength between the groups. A postoperative popeye deformity was noted in 27% of patients in the inlay group as compared with 9.4% of the onlay group ( P = .028). Four patients (10.8%) in the inlay group required revision surgery (2 of which were biceps tenodesis related) as compared with 0% in the onlay group ( P = .015). Conclusion: An onlay technique using a knotless suture anchor for ABT at the top of the articular margin is an acceptable alternative to an inlay technique using an interference screw. The onlay technique was associated with lower rates of postoperative popeye deformity and revision surgery as compared with the inlay technique.

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Section: Methodsmentioning

confidence: 99%

“…19-21 Clinically, however, subpectoral tenodesis using an onlay technique has a very low rate of revision. 11 Nevertheless, there is little information comparing outcomes of an inlay or onlay technique when performed arthroscopically high in the groove.…”

mentioning

confidence: 99%

Arthroscopic Biceps Tenodesis Outcomes: A Comparison of Inlay and Onlay Techniques

Haidamous¹,

Noyes²,

Denard

2020

Am J Sports Med

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“…16 The most common complications associated with biceps tenodesis include residual groove pain, pain or soreness in the biceps muscle belly, strength deficits in supination or elbow flexion, and cosmetic deformity. 5,18 While it has been shown that biceps tenodesis is a risk factor for revision rotator cuff repair, 7 very few studies have reported on revision biceps tenodesis. Brady et al 4 reported only 4 cases of revision biceps tenodesis (0.4%) after an open subpectoral technique, whereas Schrock et al 14 reported only 2 cases of revision biceps tenodesis (2%) for an arthroscopic technique.…”

Section: Discussionmentioning

confidence: 99%

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

Forsythe

Agarwalla

Puzzitiello

et al. 2019

Orthopaedic Journal of Sports Medicine

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Background:Biceps tenodesis may be performed for symptomatic tendinopathy or tearing of the long head of the biceps tendon. Biceps tenodesis is also commonly performed as an adjunctive procedure. However, the indications and prevalence of biceps tenodesis have expanded.Purpose:To establish the incidence and risk factors for revision biceps tenodesis.Study Design:Case-control study; Level of evidence, 2.Methods:The PearlDiver database of Humana patient data was queried for patients undergoing arthroscopic or open biceps tenodesis (Current Procedural Terminology [CPT] 29828 and CPT 23430, respectively) from 2008 through the first quarter of 2017. Patients without a CPT laterality modifier were excluded from analysis. Revision biceps tenodesis was defined as patients who underwent subsequent ipsilateral open or arthroscopic biceps tenodesis. The financial impact of revision biceps tenodesis was also calculated. Multivariate binomial logistic regression was performed to identify risk factors for revision biceps tenodesis, such as patient demographics as well as concomitant procedures and diagnoses. Odds ratios (ORs) and 95% CIs were calculated, and all statistical comparisons with P < .05 were considered significant.Results:There were 15,257 patients who underwent biceps tenodesis. Of these, 9274 patients (60.8%) underwent arthroscopic biceps tenodesis, while 5983 (39.2%) underwent open biceps tenodesis. A total of 171 patients (1.8%) and 111 patients (1.9%) required revision biceps tenodesis after arthroscopic and open biceps tenodesis, respectively (P = .5). Male sex (OR, 1.38 [95% CI, 1.04-1.85]; P = .02) was the only independent risk factor for revision biceps tenodesis after the index open biceps tenodesis. After arthroscopic biceps tenodesis, age >45 years (OR, 0.58 [95% CI, 0.39-0.89]; P = .01) and concomitant rotator cuff tear (OR, 0.58 [95% CI, 0.47-0.71]; P < .001) were independent protective factors for revision biceps tenodesis. The total cost of revision biceps tenodesis after open and arthroscopic biceps tenodesis was US$3427.95 and US$2174.33 per patient, respectively.Conclusion:There was no significant difference in the revision rate between arthroscopic and open biceps tenodesis. Risk factors for revision surgery included male sex for open biceps tenodesis, while age >45 years and rotator cuff tears were protective factors for arthroscopic biceps tenodesis.

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“…Alternatively, many surgeons favor an open subpectoral technique for biceps tenodesis using an interference screw [61], suture anchor [62], unicortical button [63], or bicortical button for fixation [64]. A recent study by Green et al demonstrated good results in a technique that involves docking the tendon into a socket in the humerus without the use of an interference screw [65].…”

Section: Biceps Tenodesismentioning

confidence: 99%

Diagnosis and Treatment of Injuries to the Biceps and Superior Labral Complex in Overhead Athletes

Calcei

Boddapati

Altchek

et al. 2018

Curr Rev Musculoskelet Med

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A focused patient history, numerous physical examination maneuvers, and appropriate advanced imaging studies must be utilized to reach an accurate diagnosis. Nonoperative management, even in overhead athletes, has demonstrated relatively good outcomes, while operative outcomes have yielded mixed results. The surgeon must take into account a number of variables when choosing the appropriate surgical procedure: labral repair versus biceps tenodesis. Rehabilitation, either as nonoperative management or as a postoperative protocol, should focus on restoring glenohumeral and scapulothoracic strength, endurance, and full, pain-free range of motion, while correcting any deficiencies in balance or rhythm throughout the overhead motion. Despite the operative treatment challenges that SLAP tears present, with new techniques and proper patient selection, overhead athletes with injuries to the biceps and superior labrum complex can return to sport at a high level.

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Low incidence of failure after proximal biceps tenodesis with unicortical suture button

Cited by 17 publications

References 24 publications

Arthroscopic Biceps Tenodesis Outcomes: A Comparison of Inlay and Onlay Techniques

Arthroscopic Biceps Tenodesis Outcomes: A Comparison of Inlay and Onlay Techniques

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

Diagnosis and Treatment of Injuries to the Biceps and Superior Labral Complex in Overhead Athletes

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