Tenodesis yields better functional results than tenotomy in long head of the biceps tendon operations—a systematic review and meta-analysis

Abstract

Background Pathology of the long head of the biceps tendon (LHBT) is a common disorder affecting muscle function and causing considerable pain for the patient. The literature on the two surgical treatment methods (tenotomy and tenodesis) is controversial; therefore, our aim was to compare the results of these interventions. Methods We performed a meta-analysis using the following strategy: (P) patients with LHBT pathology, (I) tenodesis, (C) tenotomy, (O) elbow flexion and forearm supination strength, pain assessed on the ten-point Visual Analog Scale (VAS), bicipital cramping pain, Constant, ASES, and SST score, Popeye deformity, and operative time. We included only randomized clinical trials. We searched five databases. During statistical analysis, odds ratios (OR) and weighted mean differences (WMD) were calculated for dichotomous and continuous outcomes, respectively, using the Bayesian method with random effect model. Results We included 11 studies in the systematic review, nine of these were eligible for the meta-analysis, containing data about 572 patients (279 in the tenodesis, 293 in the tenotomy group). Our analysis concluded that tenodesis is more beneficial considering 12-month elbow flexion strength (WMD: 3.67 kg; p = 0.006), 12-month forearm supination strength (WMD: 0.36 kg; p = 0.012), and 24-month Popeye deformity (OR: 0.19; p < 0.001), whereas tenotomy was associated with decreased 3-month pain scores on VAS (WMD: 0.99; p < 0.001). We did not find significant difference among the other outcomes. Conclusion Tenodesis yields better results in terms of biceps function and is non-inferior regarding long-term pain, while tenotomy is associated with earlier pain relief.

The high resistance loop (H-loop) technique used for all-inside arthroscopic knotless suprapectoral biceps tenodesis: A case series

“…The advantages of this technique are simple operation, excellent visualization, and easy to be taught and repeated under arthroscopy. At the same time, it is a cost-effective technology, because: (1) It is a simple and timeconsuming technology, which saves operation time; (2) The two suture limbs can be pressed under the lateral row handling the rotator cuff without additional implants, which The following limitations of our study must be considered. First, this tenodesis technique has potential limitations similar to those of other all-arthroscopic tenodesis techniques.…”

“…Lesions of the long head of the biceps tendon (LHBT) usually lead to pain of the shoulder and disability, and more than 60% of patients have a rotator cuff tear ( 1 ). Tenotomy and tenodesis are effective but controversial techniques for the treatment of LHBT lesions; however, there was no difference in functional results between tenotomy and tenodesis in recent studies ( 2 ).…”

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

“…Tendinopathy of the long head of the biceps tendon (LHBT), which occurs in isolation or is accompanied by other shoulder pathologies, is a common cause of anterior shoulder pain [ 2 , 28 ]. Surgical interventions for LHBT tendinopathy include tenotomy and tenodesis [ 13 , 21 , 28 ].…”

“…Tendinopathy of the long head of the biceps tendon (LHBT), which occurs in isolation or is accompanied by other shoulder pathologies, is a common cause of anterior shoulder pain [ 2 , 28 ]. 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 ].…”

Fast Arthroscopic Biceps Tenodesis Without Penetrating Grasper

“…Multiple studies previously identified LHBT injury as a cause of shoulder pain, either in isolation or in conjunction with other shoulder pathologies. 1 …”