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Berhouet J, Samargandi R, Charousset C. Management of normal long head of the biceps tendon in isolated grade-1 supraspinatus tear: Research protocol for a multicenter prospective single-blind randomized study. Orthop Traumatol Surg Res 2022; 108:103404. [PMID: 36108818 DOI: 10.1016/j.otsr.2022.103404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 08/20/2022] [Accepted: 09/02/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND The long head of the biceps (LHB) tendon is a common locus of pain in rotator cuff tear and of residual pain after tendon repair. Therefore, systematic LHB tenotomy, with or without tenodesis, is usually recommended. However, the recent literature suggests that long-term functional results of supraspinatus tendon repair are comparable between conservation of a normal biceps and tenotomy. The study objective is to compare functional results between sectioning and sparing a normal LHB in treating isolated grade-1 supraspinatus tendon tear. The study hypothesis is that sparing the normal LHB is clinically preferable to sectioning in the particular case of distal supraspinatus tear. METHODS AND ANALYSIS A French nationwide prospective single-blind randomized clinical study will include 194 patients undergoing arthroscopic repair of grade-1 supraspinatus tear with normal LHB. They will be randomized to 2 parallel groups: LHB sparing and sectioning. The main endpoint is Constant-Murley score, and secondary endpoints comprise ASES and SSV scores, clinical assessment of the biceps, pain on VAS, ultrasound assessment of cuff repair healing and conserved LHBs, impact on return to work and sport, pathologic assessment of sectioned LHBs, and analysis of risk factors for cuff repair failure. ETHICAL APPROVAL AND PUBLICATION The protocol has been approved by the data protection committee (art.L.1122-1) and meets the criteria of the Declaration of Helsinki and of the SPIRIT statement defining standard protocol items for clinical trials. Results will be published in a peer-reviewed journal. LEVEL OF EVIDENCE not applicable.
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Affiliation(s)
- Julien Berhouet
- Université de Tours-Faculté de Médecine de Tours-CHRU Trousseau, Service d'Orthopédie Traumatologie de Tours, avenue de la République, 37170 Chambray-Les-Tours, France.
| | - Ramy Samargandi
- Université de Tours-Faculté de Médecine de Tours-CHRU Trousseau, Service d'Orthopédie Traumatologie de Tours, avenue de la République, 37170 Chambray-Les-Tours, France
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- 115, rue Ampère, 92500 Rueil-Malmaison, France
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Hartland AW, Islam R, Teoh KH, Rashid MS. Clinical effectiveness of tenotomy versus tenodesis for long head of biceps pathology: a systematic review and meta-analysis. BMJ Open 2022; 12:e061954. [PMID: 36220319 PMCID: PMC9557260 DOI: 10.1136/bmjopen-2022-061954] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES The comparative clinical effectiveness of common surgical techniques to address long head of biceps (LHB) pathology is unclear. We synthesised the evidence to compare the clinical effectiveness of tenotomy versus tenodesis. DESIGN A systematic review and meta-analysis using the Grading of Recommendations Assessment, Development and Evaluation approach. DATA SOURCES EMBASE, Medline, PsycINFO and the Cochrane Library of randomised controlled trials were searched through 31 October 2021. ELIGIBILITY CRITERIA We included randomised controlled trials, reporting patient reported outcome measures, comparing LHB tenotomy with tenodesis for LHB pathology, with or without concomitant rotator cuff pathology. Studies including patients treated for superior labral anterior-posterior tears were excluded. No language limits were employed. All publications from database inception to 31 October 2021 were included. DATA EXTRACTION AND SYNTHESIS Screening was performed by two authors independently. A third author reviewed the article, where consensus for inclusion was required. Data were extracted by two authors. Data were synthesised using RevMan. Inverse variance statistics and a random effects model were used. RESULTS 860 patients from 11 RCTs (426 tenotomy vs 434 tenodesis) were included. Pooled analysis of patient-reported functional outcome measures data demonstrated comparable outcomes (n=10 studies; 403 tenotomy vs 416 tenodesis; standardised mean difference (SMD): 0.14, 95% CI -0.04 to 0.32, p=0.13). There was no significant difference for pain (Visual Analogue Scale) (n=8 studies; 345 tenotomy vs 350 tenodesis; MD: -0.11, 95% CI -0.28 to 0.06, p=0.21). Tenodesis resulted in a lower rate of Popeye deformity (n=10 studies; 401 tenotomy vs 410 tenodesis; OR: 0.29, 95% CI 0.19 to 0.45, p<0.00001). Tenotomy demonstrated shorter operative time (n=4 studies; 204 tenotomy vs 201 tenodesis; MD 15.2, 95% CI 1.06 to 29.36, p<0.00001). CONCLUSIONS Aside from a lower rate of cosmetic deformity, tenodesis yielded no significant clinical benefit to tenotomy for addressing LHB pathology. PROSPERO REGISTRATION NUMBER CRD42020198658.
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Affiliation(s)
| | - Raisa Islam
- Department of Trauma and Orthopaedic Surgery, Princess Alexandra Hospital, Harlow, UK
| | - Kar Hao Teoh
- Department of Trauma and Orthopaedic Surgery, Princess Alexandra Hospital, Harlow, UK
| | - Mustafa Saad Rashid
- Nuffield Department of Orthopaedics, Rheumatology, and Musckuloskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK
- Nuffield Department of Orthopaedics, Rheumatology, and Musckuloskeletal Sciences, Wrightington Wigan and Leigh NHS Foundation Trust, Wigan, UK
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Bozon O, Chiche L, Salabi V, Lazerges C, Chammas M, Coulet B. The IBTIS score; a new prognostic score for arthroscopic biceps tenotomies. Orthop Traumatol Surg Res 2022; 108:103114. [PMID: 34653643 DOI: 10.1016/j.otsr.2021.103114] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/30/2020] [Accepted: 02/05/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Shoulder pain associated with tendinopathy of the long head of biceps (LHB) is common. Surgical treatment with arthroscopic tenotomy of the LHB has been shown to be effective. However, it's efficacy is inconsistent. The objective of this study was to assess the pre-operative clinical and radiological prognostic factors of arthroscopic tenotomy of the long head of biceps, and to establish a predictive score for good responses to treatment; the IBTIS score (Isolated Biceps Tenotomy Index Score). HYPOTHESIS Prognostic factors representing a good response to treatment of LHB tendinopathy by arthroscopic tenotomy exist. MATERIALS AND METHODS We conducted a retrospective monocentric study including 64 patients who underwent surgery of the LHB by arthroscopic tenotomy (with or without tenodesis) between January 2018 and March 2020. We identified 2 patient groups (good responder group and poor responder group) from a 3-month post-operative clinical assessment, which included a subjective assessment comprising Single Shoulder Value (SSV), Constant score, C-Test, and pain level. Prognostic factors of a good response were then sought from the 2 groups using interviews, clinical examinations and pre-operative imaging. Based on these findings, a predictive score for a good response was established. RESULTS All evaluation criteria demonstrated post-operative improvement: mean SSV (72.2 vs 50.7; p<0.001), relative constant (78.2 vs 64.3; p<0.001), pain level (3.2 vs 7; p<0.001) and C-Test (94.1 vs 85.6; p=0.07). 34 patients (58.6%) were considered good responders, while 24 patients (41.38%) were considered poor responders. There was a trend towards a favourable result for: age>65 years (p=0.01), rotator cuff rupture on preoperative imaging (p=0.01), Cross Arm Test (p=0.02), nocturnal pain (p=0.08), Yergason's test (p=0.16) and Speed's Test (p=0.22). Manual labour appeared to be an unfavourable factor (p=0.07). These factors were incorporated into the 10-point IBTIS score. A score greater than 5 was associated with a favourable result in more than 80% of patients (p<0.001). DISCUSSION Our score consists of 7 items. We identified 7 pre-operative prognostic factors for a good result after LHB tenotomy. Over 65 years of age was found to be statistically significant in univariate analysis, as was visualization of rotator cuff rupture on pre-operative imaging. The Cross Arm Test was included given its high statistical significance. The Speed's Test and Yergason's Test are ubiquitous in the literature. Nocturnal pain was found in more than 80% of patients. Undertaking manual labour represented an unfavourable prognostic factor after arthroscopic surgery of the LHB. CONCLUSION The IBTIS score (Isolated Biceps Tenotomy Index Score) is a pre-operative clinico-radiological score for the surgical treatment of arthroscopic tenotomy of the long head of biceps. Further studies are required to validate its prognostic accuracy. LEVEL OF EVIDENCE III; case-control.
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Affiliation(s)
- Olivier Bozon
- Department of Orthopaedic Surgery, Upper Limb Surgical Unit, Lapeyronie Hospital, University Hospital of Montpellier, Montpellier, France.
| | - Léo Chiche
- Department of Orthopaedic Surgery, Upper Limb Surgical Unit, Lapeyronie Hospital, University Hospital of Montpellier, Montpellier, France
| | - Vincent Salabi
- Department of Orthopaedic Surgery, Upper Limb Surgical Unit, Lapeyronie Hospital, University Hospital of Montpellier, Montpellier, France
| | - Cyril Lazerges
- Department of Orthopaedic Surgery, Upper Limb Surgical Unit, Lapeyronie Hospital, University Hospital of Montpellier, Montpellier, France
| | - Michel Chammas
- Department of Orthopaedic Surgery, Upper Limb Surgical Unit, Lapeyronie Hospital, University Hospital of Montpellier, Montpellier, France
| | - Bertrand Coulet
- Department of Orthopaedic Surgery, Upper Limb Surgical Unit, Lapeyronie Hospital, University Hospital of Montpellier, Montpellier, France
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Vajda M, Szakó L, Hegyi P, Erőss B, Görbe A, Molnár Z, Kozma K, Józsa G, Bucsi L, Schandl K. Tenodesis yields better functional results than tenotomy in long head of the biceps tendon operations-a systematic review and meta-analysis. INTERNATIONAL ORTHOPAEDICS 2022; 46:1037-1051. [PMID: 35254476 PMCID: PMC9001564 DOI: 10.1007/s00264-022-05338-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 02/01/2022] [Indexed: 12/29/2022]
Abstract
Background Pathology of the long head of the biceps tendon (LHBT) is a common disorder affecting muscle function and causing considerable pain for the patient. The literature on the two surgical treatment methods (tenotomy and tenodesis) is controversial; therefore, our aim was to compare the results of these interventions. Methods We performed a meta-analysis using the following strategy: (P) patients with LHBT pathology, (I) tenodesis, (C) tenotomy, (O) elbow flexion and forearm supination strength, pain assessed on the ten-point Visual Analog Scale (VAS), bicipital cramping pain, Constant, ASES, and SST score, Popeye deformity, and operative time. We included only randomized clinical trials. We searched five databases. During statistical analysis, odds ratios (OR) and weighted mean differences (WMD) were calculated for dichotomous and continuous outcomes, respectively, using the Bayesian method with random effect model. Results We included 11 studies in the systematic review, nine of these were eligible for the meta-analysis, containing data about 572 patients (279 in the tenodesis, 293 in the tenotomy group). Our analysis concluded that tenodesis is more beneficial considering 12-month elbow flexion strength (WMD: 3.67 kg; p = 0.006), 12-month forearm supination strength (WMD: 0.36 kg; p = 0.012), and 24-month Popeye deformity (OR: 0.19; p < 0.001), whereas tenotomy was associated with decreased 3-month pain scores on VAS (WMD: 0.99; p < 0.001). We did not find significant difference among the other outcomes. Conclusion Tenodesis yields better results in terms of biceps function and is non-inferior regarding long-term pain, while tenotomy is associated with earlier pain relief. Supplementary Information The online version contains supplementary material available at 10.1007/s00264-022-05338-9.
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Affiliation(s)
- Mátyás Vajda
- Institute for Translational Medicine, Medical School, University of Pécs, Szigeti út 12, 2nd floor, 7624 Pécs, Hungary
- Saint George University Teaching Hospital of County-Fejér, Seregélyesi u. 3., 8000 Székesfehérvár, Hungary
- Department of Orthodaedics, Medical School, University of Pécs, Akác u. 1, 7632 Pécs, Hungary
| | - Lajos Szakó
- Institute for Translational Medicine, Medical School, University of Pécs, Szigeti út 12, 2nd floor, 7624 Pécs, Hungary
| | - Péter Hegyi
- Institute for Translational Medicine, Medical School, University of Pécs, Szigeti út 12, 2nd floor, 7624 Pécs, Hungary
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085 Hungary
| | - Bálint Erőss
- Institute for Translational Medicine, Medical School, University of Pécs, Szigeti út 12, 2nd floor, 7624 Pécs, Hungary
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085 Hungary
| | - Anikó Görbe
- Institute for Translational Medicine, Medical School, University of Pécs, Szigeti út 12, 2nd floor, 7624 Pécs, Hungary
| | - Zsolt Molnár
- Institute for Translational Medicine, Medical School, University of Pécs, Szigeti út 12, 2nd floor, 7624 Pécs, Hungary
- Department of Anaesthesiology and Intensive Therapy and Pain Management, Poznan University of Medical Sciences, 49 Przybyszewskiego St, 60-355 Poznan, Poland
| | - Kincső Kozma
- Department of Ophtalmology, Medical School, University of Pécs, Rákóczi út 2, 7623 Pécs, Hungary
| | - Gergő Józsa
- Department of Paediatrics, Surgical Division, University of Pécs, József Attila u. 7, 7623 Pécs, Hungary
| | - László Bucsi
- Saint George University Teaching Hospital of County-Fejér, Seregélyesi u. 3., 8000 Székesfehérvár, Hungary
- Department of Orthodaedics, Medical School, University of Pécs, Akác u. 1, 7632 Pécs, Hungary
| | - Károly Schandl
- Saint George University Teaching Hospital of County-Fejér, Seregélyesi u. 3., 8000 Székesfehérvár, Hungary
- Department of Orthodaedics, Medical School, University of Pécs, Akác u. 1, 7632 Pécs, Hungary
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Blaeser AM, Markus DH, Hurley ET, Gonzalez-Lomas G, Strauss EJ, Jazrawi LM. Current Controversies and Decision-Making in the Management of Biceps Pathologies. JBJS Rev 2021; 9:01874474-202112000-00008. [PMID: 34962898 DOI: 10.2106/jbjs.rvw.21.00096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
» Biceps tendon pathologies include a spectrum of injuries that range from mild tendinosis to complete tendon rupture. » Tendinosis, the most common pathology, occurs more frequently with age and is likely related to chronic degeneration. On the other side of the spectrum of severity lies a rupture of the long head of the biceps tendon (LHBT), which may be accompanied by injury to the glenoid labrum. » Superior labral anterior-posterior (SLAP) tears are frequently associated with biceps pathology. Surgical management for injuries of the bicipital-labral complex includes biceps tenodesis or tenotomy and SLAP repair. A consensus as to which of these procedures is the optimal choice has not been reached, and management may ultimately depend on patient-specific characteristics. » Due to the relatively low incidence of distal biceps tendon rupture, agreement on the optimal management strategy has not been reached. Surgical repair, or reconstruction in the case of a chronic rupture, is often chosen. However, nonoperative management has also been utilized in older, less-active patients.
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Affiliation(s)
- Anna M Blaeser
- Department of Sports Medicine, New York University Langone Health, New York, NY
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Woodmass JM, McRae SMB, Lapner PL, Sasyniuk T, Old J, Stranges G, Dubberly J, Verhulst FV, MacDonald PB. Effect of age, gender, and body mass index on incidence and satisfaction of a Popeye deformity following biceps tenotomy or tenodesis: secondary analysis of a randomized clinical trial. J Shoulder Elbow Surg 2021; 30:1733-1740. [PMID: 34022365 DOI: 10.1016/j.jse.2021.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 04/30/2021] [Accepted: 05/02/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND The purpose of this study was to determine the incidence of Popeye deformity following biceps tenotomy vs. tenodesis and evaluate risk factors and subjective and objective outcomes. METHODS Data for this study were collected as part of a randomized clinical trial in which patients aged ≥18 years undergoing arthroscopic shoulder surgery for a long head of the biceps tendon lesion were allocated to undergo tenotomy or tenodesis. The primary outcome measure for this secondary analysis was rate of Popeye deformity at 24 months postoperation as determined by an evaluator blinded to group allocation. Those with a deformity indicated their satisfaction with the appearance of their arm on a 10-cm visual analog scale, rated their pain and cramping, and completed the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form and the Western Ontario Rotator Cuff index. Isometric elbow flexion and supination strength were also measured. Cohen kappa was calculated to measure inter-rater reliability between patient and evaluator on the presence of a deformity. Logistic regression was performed to identify predictors of presence or absence of a Popeye deformity. RESULTS One hundred fourteen patients were randomly assigned to 2 groups, of which 42 to the tenodesis group and 45 to the tenotomy group completed a 24-month follow-up. Based on clinical observation, the odds of a Popeye in the tenotomy group were 4.3 times greater than in the tenodesis group (P = .018) with incidence of 33% (15/45) and 9.5% (4/42), respectively. Surgical technique was the only significant predictor of perceived deformity, with male gender trending toward significance (odds ratio 7.33, 95% confidence interval 0.867-61.906, P = .067). Mean (standard deviation) satisfaction score of those with a deformity regarding appearance of their arm was 7.3 (2.6). Increasing satisfaction was correlated with increasing age (r = 0.640, P = .025), but there was no association with gender (r = -0.155, P = .527) or body mass index (r = -0.221, P = .057). Differences in subjective outcomes were dependent on whether the Popeye was clinician- or self-assessed. CONCLUSION The odds of developing a perceived Popeye deformity was 4.3 higher after tenotomy compared to tenodesis based on clinician observation. Male gender was trending toward being predictive of having a deformity. Pain and cramping were increased in those with a self-reported Popeye. Younger patients were significantly less satisfied with a deformity despite no difference in functional outcomes at 24 months. Thus, biceps tenodesis may be favored in younger male patients to minimize the risk of Popeye and the risk of dissatisfaction in the appearance of their arm following surgery.
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Affiliation(s)
| | | | - Peter L Lapner
- Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Treny Sasyniuk
- Pan Am Clinic, University of Manitoba, Winnipeg, MB, Canada
| | - Jason Old
- Pan Am Clinic, University of Manitoba, Winnipeg, MB, Canada
| | - Greg Stranges
- Pan Am Clinic, University of Manitoba, Winnipeg, MB, Canada
| | - Jamie Dubberly
- Pan Am Clinic, University of Manitoba, Winnipeg, MB, Canada
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Hurley ET, Anil U, Kingery MT, Pauzenber L, Mullett H, Strauss EJ. Response to Cao et al regarding: "Surgical treatment for long head of the biceps tendinopathy: a network meta-analysis". J Shoulder Elbow Surg 2021; 30:e36-e37. [PMID: 32956778 DOI: 10.1016/j.jse.2020.07.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 07/13/2020] [Indexed: 02/01/2023]
Affiliation(s)
- Eoghan T Hurley
- Division of Sports Medicine, Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA; Department of Trauma and Orthopaedics, Royal College of Surgeons in Ireland, Dublin, Ireland; Sports Surgery Clinic, Dublin, Ireland.
| | - Utkarsh Anil
- Division of Sports Medicine, Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA
| | - Matthew T Kingery
- Division of Sports Medicine, Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA
| | | | | | - Eric J Strauss
- Division of Sports Medicine, Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA
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MacDonald P, Verhulst F, McRae S, Old J, Stranges G, Dubberley J, Mascarenhas R, Koenig J, Leiter J, Nassar M, Lapner P. Biceps Tenodesis Versus Tenotomy in the Treatment of Lesions of the Long Head of the Biceps Tendon in Patients Undergoing Arthroscopic Shoulder Surgery: A Prospective Double-Blinded Randomized Controlled Trial. Am J Sports Med 2020; 48:1439-1449. [PMID: 32223645 DOI: 10.1177/0363546520912212] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The biceps tendon is a known source of shoulder pain. Few high-level studies have attempted to determine whether biceps tenotomy or tenodesis is the optimal approach in the treatment of biceps pathology. Most available literature is of lesser scientific quality and shows varying results in the comparison of tenotomy and tenodesis. PURPOSE To compare patient-reported and objective clinical results between tenotomy and tenodesis for the treatment of lesions of the long head of the biceps brachii. STUDY DESIGN Randomized controlled trial; Level of evidence, 1. METHODS Patients aged ≥18 years undergoing arthroscopic surgery with intraoperative confirmation of a lesion of the long head of the biceps tendon were randomized. The primary outcome measure was the American Shoulder and Elbow Surgeons (ASES) score, while secondary outcomes included the Western Ontario Rotator Cuff Index (WORC) score, elbow and shoulder strength, operative time, complications, and the incidence of revision surgery with each procedure. Magnetic resonance imaging was performed at postoperative 1 year to evaluate the integrity of the procedure in the tenodesis group. RESULTS A total of 114 participants with a mean age of 57.7 years (range, 34 years to 86 years) were randomized to undergo either biceps tenodesis or tenotomy. ASES and WORC scores improved significantly from pre- to postoperative time points, with a mean difference of 32.3% (P < .001) and 37.3% (P < .001), respectively, with no difference between groups in either outcome from presurgery to postoperative 24 months. The relative risk of cosmetic deformity in the tenotomy group relative to the tenodesis group at 24 months was 3.5 (95% CI, 1.26-9.70; P = .016), with 4 (10%) occurrences in the tenodesis group and 15 (33%) in the tenotomy group. Pain improved from 3 to 24 months postoperatively (P < .001) with no difference between groups. Cramping was not different between groups, nor was any improvement in cramping seen over time. There were no differences between groups in elbow flexion strength or supination strength. Follow-up magnetic resonance imaging at postoperative 12 months showed that the tenodesis was intact for all patients. CONCLUSION Tenotomy and tenodesis as treatment for lesions of the long head of biceps tendon both result in good subjective outcomes but there is a higher rate of Popeye deformity in the tenotomy group. REGISTRATION NCT01747902 ( ClinicalTrials.gov identifier).
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Affiliation(s)
- Peter MacDonald
- Pan Am Clinic and University of Manitoba, Winnipeg, Manitoba, Canada
| | - Fleur Verhulst
- Pan Am Clinic and University of Manitoba, Winnipeg, Manitoba, Canada
| | - Sheila McRae
- Pan Am Clinic and University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jason Old
- Pan Am Clinic and University of Manitoba, Winnipeg, Manitoba, Canada
| | - Greg Stranges
- Pan Am Clinic and University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jamie Dubberley
- Pan Am Clinic and University of Manitoba, Winnipeg, Manitoba, Canada
| | - Randy Mascarenhas
- McGovern Medical School, University of Texas Health Sciences Center, Houston, Texas, USA
| | - James Koenig
- Pan Am Clinic and University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jeff Leiter
- Pan Am Clinic and University of Manitoba, Winnipeg, Manitoba, Canada
| | - Mark Nassar
- Pan Am Clinic and University of Manitoba, Winnipeg, Manitoba, Canada
| | - Peter Lapner
- Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada
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Moorthy V, Tan AHC. Should long head of biceps tenodesis or tenotomy be routinely performed in arthroscopic rotator cuff repairs? J Orthop 2020; 21:161-165. [PMID: 32255998 DOI: 10.1016/j.jor.2020.03.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 03/23/2020] [Indexed: 01/22/2023] Open
Abstract
Purpose The long head of the biceps tendon (LHBT) lesions are frequently associated with partial or complete rotator cuff tears (RCTs), but controversy revolves around their optimal surgical management. Methods Hence this article aims to review the current literature available on the role of biceps surgery in rotator cuff surgery and whether it should be routinely performed in rotator cuff repairs. Results Furthermore, we also discuss the advantages and drawbacks of tenotomy or tenodesis of LHBT in rotator cuff surgery. Conclusion We conclude this article with recommendations for surgeons performing rotator cuff repairs and future research in this area.
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Affiliation(s)
- Vikaesh Moorthy
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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“Tomydesis” might be a reliable technique for lesions of the long head of the biceps tendon associated with rotator cuff tears: a minimum 6-month prospective clinical follow-up study. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2019; 30:83-87. [DOI: 10.1007/s00590-019-02525-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 07/30/2019] [Indexed: 01/17/2023]
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