Improvement in long head of biceps function and lower rate of biceps deformities after subpectoral tenodesis with cortical button and interference screw vs. arthroscopic tenotomy: a 4-year follow-up
Background: This study aimed to evaluate clinical, cosmetic, and strength midterm outcomes in arthroscopic biceps tenotomy and subpectoral biceps tenodesis using bicortical endobutton and interference screw. Methods: In this retrospective study, inclusion criteria were long head of the biceps (LHB)...
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Elsevier
2022-09-01
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| Series: | JSES International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S266663832200127X |
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| author | Filipe Ferreira Carvalho, MD, MSc Philip-Christian Nolte, MD, MA Joao Pinheiro, MD Thorsten Guehring, MD Michael Egenolf, MD Thomas Chatterjee, MD |
| author_facet | Filipe Ferreira Carvalho, MD, MSc Philip-Christian Nolte, MD, MA Joao Pinheiro, MD Thorsten Guehring, MD Michael Egenolf, MD Thomas Chatterjee, MD |
| author_sort | Filipe Ferreira Carvalho, MD, MSc |
| collection | DOAJ |
| description | Background: This study aimed to evaluate clinical, cosmetic, and strength midterm outcomes in arthroscopic biceps tenotomy and subpectoral biceps tenodesis using bicortical endobutton and interference screw. Methods: In this retrospective study, inclusion criteria were long head of the biceps (LHB) pathologies treated either with tenotomy or an additional tenodesis. Postoperative assessment included Long Head of Biceps Score (LHBS), age-adjusted Constant-Murley Score, and Subjective Shoulder Value. Elbow flexion and forearm supination strength were measured. The presence of Popeye sign, cramps, and tenderness over the bicipital grove was evaluated. Statistical analysis of continuous variables without normal distribution was performed using Mann-Whitney U test. Grouped analysis was performed using 2-way analysis of variance. Binominal data were analyzed using chi-square test. Results: A total of 73 patients with a mean age of 63.1 ± 9.6 years and a mean follow-up of 4.2 ± 0.5 years were included. Tenotomy was performed in 34 and tenodesis in 39 patients. Tenodesis group displayed a significantly higher LHB score (P = .0006), but no significant differences were detected for the age-adjusted Constant-Murley Score and Subjective Shoulder Value. Tenodesis group showed a significantly lower rate of Popeye deformities (P = .0007) and tenderness over the bicipital groove (P = .004). Patients from the tenotomy group with biceps deformity showed a significantly higher mean contralateral supination strength (P = .002) but no significant difference in contralateral elbow flexion compared with patients without biceps deformity. There was one (1.4%) complication in the tenotomy group (postoperative shoulder stiffness). Conclusion: Both techniques resulted in comparable outcome scores on preselected patients, with tenodesis leading to better LHB function. Tenodesis did not improve elbow flexion and forearm supination strength beyond the tenotomy; however, it reduced the frequency of biceps deformities and tenderness over the bicipital groove. Patients with a strong contralateral forearm supination strength could be at risk of developing a biceps deformity after tenotomy. |
| first_indexed | 2024-04-13T01:59:29Z |
| format | Article |
| id | doaj.art-79b302db6e384bef8e8c7523c27269ab |
| institution | Directory Open Access Journal |
| issn | 2666-6383 |
| language | English |
| last_indexed | 2024-04-13T01:59:29Z |
| publishDate | 2022-09-01 |
| publisher | Elsevier |
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| series | JSES International |
| spelling | doaj.art-79b302db6e384bef8e8c7523c27269ab2022-12-22T03:07:39ZengElsevierJSES International2666-63832022-09-0165820827Improvement in long head of biceps function and lower rate of biceps deformities after subpectoral tenodesis with cortical button and interference screw vs. arthroscopic tenotomy: a 4-year follow-upFilipe Ferreira Carvalho, MD, MSc0Philip-Christian Nolte, MD, MA1Joao Pinheiro, MD2Thorsten Guehring, MD3Michael Egenolf, MD4Thomas Chatterjee, MD5Evangelisches Krankenhaus, Clinic for Trauma and Orthopaedic Surgery, Bad Dürkheim, Germany; Medical Faculty Heidelberg of Heidelberg University, Heidelberg, Germany; Corresponding author: Filipe Ferreira Carvalho, MD, MSc, Evangelisches Krankenhaus, Orthopädie und Unfallchirurgie, Dr.-Kaufmann-Str. 2, 67098 Bad Dürkheim, Germany.BG Trauma Center Ludwigshafen at the University of Heidelberg, Clinic for Trauma and Orthopaedic Surgery, Ludwigshafen, GermanyEvangelisches Krankenhaus, Clinic for Trauma and Orthopaedic Surgery, Bad Dürkheim, GermanyDiakonie Klinikum, Paulinenhilfe, Clinic for Trauma Orthopaedic Surgery, Stuttgart, GermanyEvangelisches Krankenhaus, Clinic for Trauma and Orthopaedic Surgery, Bad Dürkheim, GermanyEvangelisches Krankenhaus, Clinic for Trauma and Orthopaedic Surgery, Bad Dürkheim, GermanyBackground: This study aimed to evaluate clinical, cosmetic, and strength midterm outcomes in arthroscopic biceps tenotomy and subpectoral biceps tenodesis using bicortical endobutton and interference screw. Methods: In this retrospective study, inclusion criteria were long head of the biceps (LHB) pathologies treated either with tenotomy or an additional tenodesis. Postoperative assessment included Long Head of Biceps Score (LHBS), age-adjusted Constant-Murley Score, and Subjective Shoulder Value. Elbow flexion and forearm supination strength were measured. The presence of Popeye sign, cramps, and tenderness over the bicipital grove was evaluated. Statistical analysis of continuous variables without normal distribution was performed using Mann-Whitney U test. Grouped analysis was performed using 2-way analysis of variance. Binominal data were analyzed using chi-square test. Results: A total of 73 patients with a mean age of 63.1 ± 9.6 years and a mean follow-up of 4.2 ± 0.5 years were included. Tenotomy was performed in 34 and tenodesis in 39 patients. Tenodesis group displayed a significantly higher LHB score (P = .0006), but no significant differences were detected for the age-adjusted Constant-Murley Score and Subjective Shoulder Value. Tenodesis group showed a significantly lower rate of Popeye deformities (P = .0007) and tenderness over the bicipital groove (P = .004). Patients from the tenotomy group with biceps deformity showed a significantly higher mean contralateral supination strength (P = .002) but no significant difference in contralateral elbow flexion compared with patients without biceps deformity. There was one (1.4%) complication in the tenotomy group (postoperative shoulder stiffness). Conclusion: Both techniques resulted in comparable outcome scores on preselected patients, with tenodesis leading to better LHB function. Tenodesis did not improve elbow flexion and forearm supination strength beyond the tenotomy; however, it reduced the frequency of biceps deformities and tenderness over the bicipital groove. Patients with a strong contralateral forearm supination strength could be at risk of developing a biceps deformity after tenotomy.http://www.sciencedirect.com/science/article/pii/S266663832200127XTenotomySubpectoral tenodesisPopeyeArthroscopyFlexionSupination |
| spellingShingle | Filipe Ferreira Carvalho, MD, MSc Philip-Christian Nolte, MD, MA Joao Pinheiro, MD Thorsten Guehring, MD Michael Egenolf, MD Thomas Chatterjee, MD Improvement in long head of biceps function and lower rate of biceps deformities after subpectoral tenodesis with cortical button and interference screw vs. arthroscopic tenotomy: a 4-year follow-up JSES International Tenotomy Subpectoral tenodesis Popeye Arthroscopy Flexion Supination |
| title | Improvement in long head of biceps function and lower rate of biceps deformities after subpectoral tenodesis with cortical button and interference screw vs. arthroscopic tenotomy: a 4-year follow-up |
| title_full | Improvement in long head of biceps function and lower rate of biceps deformities after subpectoral tenodesis with cortical button and interference screw vs. arthroscopic tenotomy: a 4-year follow-up |
| title_fullStr | Improvement in long head of biceps function and lower rate of biceps deformities after subpectoral tenodesis with cortical button and interference screw vs. arthroscopic tenotomy: a 4-year follow-up |
| title_full_unstemmed | Improvement in long head of biceps function and lower rate of biceps deformities after subpectoral tenodesis with cortical button and interference screw vs. arthroscopic tenotomy: a 4-year follow-up |
| title_short | Improvement in long head of biceps function and lower rate of biceps deformities after subpectoral tenodesis with cortical button and interference screw vs. arthroscopic tenotomy: a 4-year follow-up |
| title_sort | improvement in long head of biceps function and lower rate of biceps deformities after subpectoral tenodesis with cortical button and interference screw vs arthroscopic tenotomy a 4 year follow up |
| topic | Tenotomy Subpectoral tenodesis Popeye Arthroscopy Flexion Supination |
| url | http://www.sciencedirect.com/science/article/pii/S266663832200127X |
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