LOS ANGELES — Compared with tenotomy, tenodesis had nearly double the improvement in ASES score among younger patients with larger rotator cuff tears, according to results presented at the Arthroscopy Association of North America Annual Meeting.
“Biceps tenodesis is superior to tenotomy in patients less than 55 years of age,” Michael Kissenberth, MD, said in his presentation. “Incidentally, we saw those patients who had small tears and no biceps procedure had similarly less-favorable results.”
Kissenberth and colleagues retrospectively reviewed 153 patients who underwent rotator cuff repair with concomitant biceps procedure following surgery and at 2-year follow-up. Before and after surgery, patients completed validated outcomes scores, including the American Shoulder and Elbow Surgeons (ASES) score. The researchers stratified patients by age, rotator cuff tear size and whether they underwent tenotomy or tenodesis.
Overall, the researchers identified 68 tenodeses and 60 tenotomies. Although results showed no differences in baseline ASES scores or demographics between groups, patients displayed overall improvements in ASES scores postoperatively. However, the researchers found no differences between biceps modalities within each rotator cuff tear-size group.
Kissenberth noted postoperative ASES scores had nearly twice the improvement among patients younger than 55 years of age with rotator cuff tears larger than 4 cm and biceps tenodesis vs. patients with biceps tenotomy.
“If we look at the large tears, these are greater than 4 cm in patients under the age of 55, we saw significant difference in the post-last follow-up ASES score, which was significant,” Kissenberth said. “Further showing this, the ASES mean score in those greater than 4 cm showed a 51.5 change vs. tenotomy-only at 27.9.”
Additionally, Kissenberth said patients who did not undergo the biceps procedure and who had small tears did not score very well. – by Casey Tingle
Kissenberth M, et al. Paper# SS-18. Presented at: Arthroscopy Association of North America Annual Meeting. April 23-25, 2015; Los Angeles.
Disclosure: Kissenberth reports he is on the board of the Hawkins Foundation and of the American Orthopaedic Society of Sports Medicine.