Tenodesis, tenotomy showed favorable results in treatment of long head of biceps tendon lesions
DENVER — Results presented at the Arthroscopy Association of North America Annual Meeting showed favorable results with both tenodesis and tenotomy in the treatment of lesions of the long head of the biceps tendon.
“Arthroscopic treatment of lesions of [the] long head of [the] biceps with a tenodesis or tenotomy were shown to have favorable results,” Jeffrey R. S. Leiter, MSc, PhD, said in his presentation.
Leiter and colleagues randomly assigned 112 patients with a lesion of the long head of the biceps tendon to undergo either arthroscopic tenodesis or tenotomy. The primary outcome measure was the ASES score and secondary outcome measures included the Western Ontario Rotator Cuff subjective questionnaire, the incidence of revision surgery and shoulder strength, which was measured by annual muscle testing and with a handheld dynamometer.
“The integrity of the procedure was verified with MRI at 1-year follow-up,” Leiter said.
Leiter noted improvement in ASES scores until 6 months, with no difference between the tenodesis and tenotomy groups up to 1-year follow-up. He also noted improvement in the Western Ontario Rotator Cuff subjective scores up to 6 months, with no difference between the groups. He said patients had low levels of pain, which continued to decrease up to 1-year follow-up, and patients had low levels of cramping.
“When we look at the relative risk of Popeye deformity in the tenotomy group at 3 months, it was significant and this tapered off by 1-year follow-up,” Leiter said.
Although patients in the tenodesis group had greater elbow flexion strength at 6 months, results showed this leveled off after 12 months. Researchers reviewed MRI findings among 32 patients in the tenotomy group and 34 patients in the tenodesis group at 12 months. The tenodesis group had 18 biceps still in groove, five were suprapectoral and 11 were subpectoral, according to Leiter.
“It was interesting to note that seven of [the biceps] were partially or completely torn on MRI,” he said. – by Casey Tingle
Leiter JRS, et al. Paper #SS-28. Presented at: Arthroscopy Association of North America Annual Meeting; May 18-20, 2017; Denver.
Disclosure: Leiter reports no relevant financial disclosures.