Combined, Single-Anchor Subscapularis Tendon Repair and Proximal Biceps Tenodesis Leads to Improved Function and Decreased Pain at 1 Year

Purpose: To evaluate the 1-year clinical outcomes of patients treated with combined proximal biceps tenodesis and repair of type II to III subscapularis tendon (SST) injuries according to Lafosse et al., using the Loop ‘N’ Tack (LNT) technique. Methods: All patients undergoing proximal biceps tenode...

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Main Authors: Lucas Bartlett, D.O., Brandon Klein, D.O., M.B.A, Christopher Brancato, M.S., M.P.H., Sam Akhavan, M.D., James M. Paci, M.D.
Format: Article
Language:English
Published: Elsevier 2024-04-01
Series:Arthroscopy, Sports Medicine, and Rehabilitation
Online Access:http://www.sciencedirect.com/science/article/pii/S2666061X24000385
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author Lucas Bartlett, D.O.
Brandon Klein, D.O., M.B.A
Christopher Brancato, M.S., M.P.H.
Sam Akhavan, M.D.
James M. Paci, M.D.
author_facet Lucas Bartlett, D.O.
Brandon Klein, D.O., M.B.A
Christopher Brancato, M.S., M.P.H.
Sam Akhavan, M.D.
James M. Paci, M.D.
author_sort Lucas Bartlett, D.O.
collection DOAJ
description Purpose: To evaluate the 1-year clinical outcomes of patients treated with combined proximal biceps tenodesis and repair of type II to III subscapularis tendon (SST) injuries according to Lafosse et al., using the Loop ‘N’ Tack (LNT) technique. Methods: All patients undergoing proximal biceps tenodesis and rotator cuff repair between March 1, 2020, and January 30, 2022, were retrospectively identified. Only patients undergoing combined proximal biceps tenodesis and repair of grade II or III SST injuries with a minimum follow-up of 1 year were included. All patients underwent combined single-anchor proximal biceps tenodesis and SST repair using the LNT technique. The following outcome scores were recorded at a final follow-up of 1 year postoperatively and compared with baseline, preoperative values: American Shoulder and Elbow Score (ASES), Single Assessment Numerical Evaluation (SANE), Veterans Rand 12 Item Health Survey (VR-12), and visual analog scale (VAS). The minimal clinically important difference (MCID) for all outcome indices was determined with a distribution-based method. Results: A total of 41 consecutive patients were included. The MCID values for VAS pain, ASES, SANE, and VR-12 mental scores were 0.97, 8.5, 10.9, and 6.0 respectively. At 1-year final follow-up, approximately 95% (39/41) of patients exceeded the MCID for VAS pain scores, 90% (37/41) of patients for ASES scores, 85.4% (34/41) of patients for SANE scores, and 75.6% (31/41) of patients for VR-12 mental health scores. On average, ASES and SANE scores improved by 37 (preoperatively: 45.2, 1 year: 82.4, P < .001) and 38 points (preoperatively: 38.0, 1 year: 75.7, P < .001), respectively, while VAS scores decreased by 4 points (preoperatively: 5.49, 1 year: 1.48, P < .001). Approximately 88% (36/41) of patients were satisfied at 1 year postoperatively. Treatment failure was observed in 1 patient (2.4%). Conclusions: Patients treated with combined, single-anchor SST repair and LNT proximal biceps tenodesis achieved significant improvements in function, high satisfaction, and low rates of reoperation at 1 year postoperatively. Additionally, 76% to 95% of patients met the MCID for VAS pain, ASES, SANE, and VR-12 mental health scores. Level of Evidence: Level IV, retrospective case series.
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spelling doaj.art-6126b4063e594ad2b252ae2d52fd87c62024-03-22T05:40:40ZengElsevierArthroscopy, Sports Medicine, and Rehabilitation2666-061X2024-04-0162100920Combined, Single-Anchor Subscapularis Tendon Repair and Proximal Biceps Tenodesis Leads to Improved Function and Decreased Pain at 1 YearLucas Bartlett, D.O.0Brandon Klein, D.O., M.B.A1Christopher Brancato, M.S., M.P.H.2Sam Akhavan, M.D.3James M. Paci, M.D.4Department of Orthopedic Surgery, Huntington Hospital, Northwell Health, Donald and Barbara Zucker School Of Medicine at Hofstra, Huntington, New York, U.S.A.; Address correspondence to Lucas Bartlett, D.O., 270 Park Avenue, Huntington, NY 11743, U.S.A.Department of Orthopedic Surgery, Huntington Hospital, Northwell Health, Donald and Barbara Zucker School Of Medicine at Hofstra, Huntington, New York, U.S.A.Lake Erie College of Osteopathic Medicine, Erie, Pennsylvania, U.S.A.Department of Orthopedic Surgery, Allegheny Health Network, Pittsburgh, Pennsylvania, U.S.A.Department of Orthopedic Surgery, Huntington Hospital, Northwell Health, Donald and Barbara Zucker School Of Medicine at Hofstra, Huntington, New York, U.S.A.; Orlin and Cohen Orthopedic Group, Rockville Center, New York, U.S.A.Purpose: To evaluate the 1-year clinical outcomes of patients treated with combined proximal biceps tenodesis and repair of type II to III subscapularis tendon (SST) injuries according to Lafosse et al., using the Loop ‘N’ Tack (LNT) technique. Methods: All patients undergoing proximal biceps tenodesis and rotator cuff repair between March 1, 2020, and January 30, 2022, were retrospectively identified. Only patients undergoing combined proximal biceps tenodesis and repair of grade II or III SST injuries with a minimum follow-up of 1 year were included. All patients underwent combined single-anchor proximal biceps tenodesis and SST repair using the LNT technique. The following outcome scores were recorded at a final follow-up of 1 year postoperatively and compared with baseline, preoperative values: American Shoulder and Elbow Score (ASES), Single Assessment Numerical Evaluation (SANE), Veterans Rand 12 Item Health Survey (VR-12), and visual analog scale (VAS). The minimal clinically important difference (MCID) for all outcome indices was determined with a distribution-based method. Results: A total of 41 consecutive patients were included. The MCID values for VAS pain, ASES, SANE, and VR-12 mental scores were 0.97, 8.5, 10.9, and 6.0 respectively. At 1-year final follow-up, approximately 95% (39/41) of patients exceeded the MCID for VAS pain scores, 90% (37/41) of patients for ASES scores, 85.4% (34/41) of patients for SANE scores, and 75.6% (31/41) of patients for VR-12 mental health scores. On average, ASES and SANE scores improved by 37 (preoperatively: 45.2, 1 year: 82.4, P < .001) and 38 points (preoperatively: 38.0, 1 year: 75.7, P < .001), respectively, while VAS scores decreased by 4 points (preoperatively: 5.49, 1 year: 1.48, P < .001). Approximately 88% (36/41) of patients were satisfied at 1 year postoperatively. Treatment failure was observed in 1 patient (2.4%). Conclusions: Patients treated with combined, single-anchor SST repair and LNT proximal biceps tenodesis achieved significant improvements in function, high satisfaction, and low rates of reoperation at 1 year postoperatively. Additionally, 76% to 95% of patients met the MCID for VAS pain, ASES, SANE, and VR-12 mental health scores. Level of Evidence: Level IV, retrospective case series.http://www.sciencedirect.com/science/article/pii/S2666061X24000385
spellingShingle Lucas Bartlett, D.O.
Brandon Klein, D.O., M.B.A
Christopher Brancato, M.S., M.P.H.
Sam Akhavan, M.D.
James M. Paci, M.D.
Combined, Single-Anchor Subscapularis Tendon Repair and Proximal Biceps Tenodesis Leads to Improved Function and Decreased Pain at 1 Year
Arthroscopy, Sports Medicine, and Rehabilitation
title Combined, Single-Anchor Subscapularis Tendon Repair and Proximal Biceps Tenodesis Leads to Improved Function and Decreased Pain at 1 Year
title_full Combined, Single-Anchor Subscapularis Tendon Repair and Proximal Biceps Tenodesis Leads to Improved Function and Decreased Pain at 1 Year
title_fullStr Combined, Single-Anchor Subscapularis Tendon Repair and Proximal Biceps Tenodesis Leads to Improved Function and Decreased Pain at 1 Year
title_full_unstemmed Combined, Single-Anchor Subscapularis Tendon Repair and Proximal Biceps Tenodesis Leads to Improved Function and Decreased Pain at 1 Year
title_short Combined, Single-Anchor Subscapularis Tendon Repair and Proximal Biceps Tenodesis Leads to Improved Function and Decreased Pain at 1 Year
title_sort combined single anchor subscapularis tendon repair and proximal biceps tenodesis leads to improved function and decreased pain at 1 year
url http://www.sciencedirect.com/science/article/pii/S2666061X24000385
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