SAN DIEGO — Revision biceps tenodesis after previous failed tenodesis or tenotomy yielded high patient satisfaction and significant improvement in functional outcomes, according to results presented here.
“Revision to subpectoral biceps tenodesis is a reasonable option for failure of a suprapectoral tenotomy or any type of tenodesis,” David Savin, MD, said in his presentation at the American Orthopaedic Society for Sports Medicine Annual Meeting. “Patients should be counseled on possible high complication rates with persistent pain being the most common complaint.”
Among 50 patients who underwent subpectoral biceps tenodesis for a failed tenotomy, Savin and colleagues found 36 patients that had 2-year follow-up data with a mean follow-up of 5 years.
“When comparing preoperative to postoperative scores, we had significant improvements in VAS, simple shoulder test, functional scores, [American Shoulder and Elbow Surgeons] ASES scores and forward flexion,” Savin said. “There were no significant improvements in the [single assessment numerical evaluation] SANE score, strength, abduction or external rotation, although some of these did approach clinical significance.”
Although 12 patients experienced postoperative complications, with two patients requiring reoperation, Savin noted 31 of 36 patients said they would undergo the surgery again. Patients had a satisfaction rate of 86%, he added.
Workers’ compensation patients and patients with concomitant rotator cuff repair had more complication rates, according to Savin, while women had a higher complication rate.
“Workmans’ compensation patients were more likely to be dissatisfied and, except for functional scores, there was no significant difference between outcome scores between workmans’ compensation and private insurance,” Savin said.
Pain was the primary mode of failure for suprapectoral biceps tenodesis, according to Savin, and re-rupture was the mode of failure for subpectoral tenodesis.
“Also look at lag time from index surgery to revision, the suprapectoral biceps tenodesis had a significantly longer lag time to surgery with over half of our patients for subpectoral biceps tenodesis having surgery within 4 months,” Savin said. – by Casey Tingle
Savin D, et al. Abstract 151. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 5-8, 2018; San Diego.
Disclosure: Savin reports he receives other financial or material support from DJ Orthopaedics.