Suprapectoral versus subpectoral tenodesis for Long Head Biceps Brachii tendinopathy: A systematic review and meta-analysis

Deurzen, Derek F.P. van; Gurnani, Navin; Alta, T.D.W.; Willems, Jore H.; Onstenk, Ron; Bekerom, Michel P.J. van den

doi:10.1016/j.otsr.2020.01.004

Cited by 24 publications

(17 citation statements)

References 41 publications

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“…and subpectoral tenodeses had similar clinical improvements as was also confirmed by a recent focused comparative meta-analysis. 48 It is of special interest in the present review that including or excluding lower-quality studies (that is, level 2 and 3 studies) did not change the results of the meta-analysis. Therefore, the usefulness of nonrandomized studies should not be underestimated.…”

Section: Outcomes Of Biceps Tenotomy and Tenodesismentioning

confidence: 79%

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Tenotomy or Tenodesis for Tendinopathy of the Long Head of the Biceps Brachii: An Updated Systematic Review and Meta-analysis

Kooistra¹,

Gurnani²,

Weening³

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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The purpose of this meta-analysis was to provide an up-to-date comparison of clinical outcomes of tenotomy and tenodesis in the surgical treatment of long head of the biceps brachii (LHB) tendinopathy. Methods: A literature search was conducted in EMBASE, Pubmed/Medline and the Cochrane database from January 2000 to May 2020. All studies comparing clinical outcomes between LHB tenotomy and tenodesis were included. Quality was assessed using the Coleman score. Results: We included 25 studies (8 randomized studies) comprising 2,191 patients undergoing LHB tenotomy or tenodesis, with or without concomitant shoulder procedures (mainly rotator cuff repairs). The Coleman score ranged from 29 to 97 for all studies. When comparing tenodesis and tenotomy in randomized studies, no clinically relevant differences were found in the Constant score (mean difference, 0.9 points), the American Shoulder and Elbow Society Score (mean difference, 1.1 points), shoulder pain (mean difference in visual analogue scale, -0.3 points), elbow flexion strength loss (mean difference, 0%), or forearm supination strength (mean difference, 3%). A Popeye deformity (odds ratio, 0.32) was less commonly seen in patients treated with tenodesis (9% vs 23%). Conclusion: In our metaanalysis, a Popeye deformity was more frequently observed in patients treated with tenotomy. Based on a substantial number of studies, there is no evidence-based benefit of LHB tenodesis over tenotomy in terms of shoulder function, shoulder pain or biceps-related strength. It is unclear whether LHB tenodesis is of benefit in specific patient groups such as younger individuals. Level of evidence: Level III, systematic review of level III or higher studies.

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Section: Outcomes Of Biceps Tenotomy and Tenodesismentioning

confidence: 79%

“…Suprapectoral and subpectoral tenodeses had similar clinical improvements as was also confirmed by a recent focused comparative meta-analysis. 48 …”

Section: Discussionmentioning

confidence: 99%

Tenotomy or Tenodesis for Tendinopathy of the Long Head of the Biceps Brachii: An Updated Systematic Review and Meta-analysis

Kooistra¹,

Gurnani²,

Weening³

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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“…Described suprapectoral arthroscopic techniques have included tenodesis sites proximal, within, or distal to the bicipital groove. 11,14,25,26 In a systematic review and meta-analysis including 7 retrospective studies with 409 patients, 187 treated with suprapectoral tenodesis, and 222 with subpectoral tenodesis, van Deurzen et al 6 evaluated outcome measures including American Shoulder and Elbow Surgeons (ASES), ConstanteMurley Score, visual analog scale, bicipital groove pain, and Popeye deformity. The mean difference in ASES score, while statistically significant in favor of subpectoral tenodesis, did not meet clinical relevance.…”

Section: Discussionmentioning

confidence: 99%

“… 4 , 5 Regardless of its biomechanical function, it is a frequent cause of pain in the shoulder. 6 The reasons for pathology are numerus and include tenosynovitis, tearing, instability, and superior labral tear 7 ( Table 1 ).…”

mentioning

confidence: 99%

Arthroscopic Single-Portal Suprapectoral Biceps Tenodesis With All-Suture Anchor

Kannan

Cogan

Zhang

2022

Arthroscopy Techniques

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Tenodesis of the long head of the biceps tendon can be performed through arthroscopic and open techniques with various fixation methods and at different locations on the humerus. Many techniques have been described, with controversy surrounding the advantages and disadvantages of each. In this Technical Note, we describe an allarthroscopic, intra-articular, single-portal, suprapectoral biceps tenodesis with an all-suture anchor. This technique also allows for suture passage through the biceps tendon before tenotomy to ensure proper maintenance of the lengthetension relationship of the biceps musculotendinous unit.

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“…The former can be further subcategorized depending on the location of fixation with respect to the bicipital groove: above, within, or below the groove. The multitude of techniques have generally produced good to excellent clinical results, [5][6][7] and the specific technique used largely depends on surgeon preference.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided Suprapectoral Tenodesis of the Long Head of the Biceps Brachii

Andersen¹,

Barcelos²,

Raffaelli³

et al. 2020

Arthroscopy Techniques

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When the long head of the biceps tendon is diseased, tenodesis is an appropriate treatment strategy. The specific technique used is dependent on visualization, fixation method and hardware, and tenodesis location. For suprapectoral tenodesis techniques, those that fix the tendon within or below the bicipital groove can be challenging owing to the transverse humeral ligament covering the groove. To accurately identify the biceps tendon in this area, the ligament often requires resection. Ultrasound provides surgeons with a safe and noninvasive tool to visualize the biceps tendon as it exits the bicipital groove, negating the need for unroofing and other pitfalls associated with traditional techniques. This technical note describes an ultrasound-guided suprapectoral biceps tenodesis procedure.

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Suprapectoral versus subpectoral tenodesis for Long Head Biceps Brachii tendinopathy: A systematic review and meta-analysis

Cited by 24 publications

References 41 publications

Tenotomy or Tenodesis for Tendinopathy of the Long Head of the Biceps Brachii: An Updated Systematic Review and Meta-analysis

Tenotomy or Tenodesis for Tendinopathy of the Long Head of the Biceps Brachii: An Updated Systematic Review and Meta-analysis

Arthroscopic Single-Portal Suprapectoral Biceps Tenodesis With All-Suture Anchor

Ultrasound-Guided Suprapectoral Tenodesis of the Long Head of the Biceps Brachii

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