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Comparison of the Clinical Outcomes of Chronic Rupture, Arthroscopic Tenotomy and Tenodesis of Proximal Biceps Tendon

Year 2022, Volume: 39 Issue: 3, 728 - 732, 30.08.2022

Abstract

Biceps tendon disorders are substantial cause of intense shoulder pain thus require a careful medical attention. We compared the clinical outcomes of chronic rupture, tenotomy and tenodesis of proximal biceps tendon of patients underwent arthroscopic shoulder surgery. We included 98 patients over 50 years-old who underwent arthroscopic surgery for rotator cuff tears and grouped as tenotomy, tenodesis and chronic rupture of biceps tendon. Preoperative and postoperative 24-months follow-up Visual Analog Scale (VAS) score and the University of California–Los Angeles (UCLA) Shoulder Scale scores were compared. Chronic biceps rupture was the most common pathology in massive rotator cuff rupture group (75.9%). As tenotomy, tenodesis and chronic rupture groups were compared in terms of VAS and UCLA score improvements (preoperative and postoperative change); tenotomy showed better outcomes and there was a significant difference between tenotomy and tenodesis groups in terms of improvements in VAS and UCLA scores (p = 0.036, p = 0.010, respectively). No significant difference between chronic rupture and tenodesis in terms of VAS and UCLA scores improvements were observed (p = 1.000, p = 0.250, respectively). Also, tenotomy showed superior VAS score improvement than chronic tendon rupture (p=0.024) however no significant difference was observed in UCLA score improvement between tenotomy and chronic rupture (p = 0.527). According to our study, tenotomy seems to be a more appropriate surgical method than tenodesis in massive and full-thickness rotator cuff tears with severe biceps tendon degeneration, and also it is not necessary to perform tenodesis in cases with chronic biceps rupture.

References

  • Referans1. Beall DP, Williamson EE, Ly JQ, Adkins MC, Emery RL, Jones TP, et al. Association of biceps tendon tears with rotator cuff abnormalities: degree of correlation with tears of the anterior and superior portions of the rotator cuff. AJR American journal of roentgenology. 2003;180(3):633-9
  • Referans2. Belay ES, Wittstein JR, Garrigues GE, Lassiter TE, Scribani M, Goldner RD, et al. Biceps tenotomy has earlier pain relief compared to biceps tenodesis: a randomized prospective study. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. 2019;27(12):4032-7
  • Referans3. Boileau P, Baqué F, Valerio L, Ahrens P, Chuinard C, Trojani C. Isolated arthroscopic biceps tenotomy or tenodesis improves symptoms in patients with massive irreparable rotator cuff tears. The Journal of bone and joint surgery American volume. 2007;89(4):747-57
  • Referans4. Braun S, Horan MP, Elser F, Millett PJ. Lesions of the biceps pulley. The American journal of sports medicine. 2011;39(4):790-5
  • Referans5. Carter AN, Erickson SM. Proximal biceps tendon rupture: primarily an injury of middle age. The Physician and sportsmedicine. 1999;27(6):95-101
  • Referans6. Castricini R, Familiari F, De Gori M, Riccelli DA, De Benedetto M, Orlando N, et al. Tenodesis is not superior to tenotomy in the treatment of the long head of biceps tendon lesions. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. 2018;26(1):169-75
  • Referans7. Chen CH, Hsu KY, Chen WJ, Shih CH. Incidence and severity of biceps long head tendon lesion in patients with complete rotator cuff tears. The Journal of trauma. 2005;58(6):1189-93
  • Referans8. De Carli A, Vadalà A, Zanzotto E, Zampar G, Vetrano M, Iorio R, et al. Reparable rotator cuff tears with concomitant long-head biceps lesions: tenotomy or tenotomy/tenodesis? Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. 2012;20(12):2553-8
  • Referans9. Franceschi F, Longo UG, Ruzzini L, Papalia R, Rizzello G, Denaro V. To detach the long head of the biceps tendon after tenodesis or not: outcome analysis at the 4-year follow-up of two different techniques. International orthopaedics. 2007;31(4):537-45
  • Referans10. Friedman JL, FitzPatrick JL, Rylander LS, Bennett C, Vidal AF, McCarty EC. Biceps Tenotomy Versus Tenodesis in Active Patients Younger Than 55 Years: Is There a Difference in Strength and Outcomes? Orthopaedic journal of sports medicine. 2015;3(2):2325967115570848
  • Referans11. Frost A, Zafar MS, Maffulli N. Tenotomy versus tenodesis in the management of pathologic lesions of the tendon of the long head of the biceps brachii. The American journal of sports medicine. 2009;37(4):828-33
  • Referans12. Gill TJ, McIrvin E, Mair SD, Hawkins RJ. Results of biceps tenotomy for treatment of pathology of the long head of the biceps brachii. Journal of shoulder and elbow surgery. 2001;10(3):247-9
  • Referans13. Habermeyer P, Walch G. The biceps tendon and rotator cuff disease. In: Burkhead WZ Jr, ed. Rotator Cuff Disorders. Media, PA: Williams & Wilkins; 1996:142.
  • Referans14. Hufeland M, Wicke S, Verde PE, Krauspe R, Patzer T. Biceps tenodesis versus tenotomy in isolated LHB lesions: a prospective randomized clinical trial. Archives of orthopaedic and trauma surgery. 2019;139(7):961-70
  • Referans15. Kelly AM, Drakos MC, Fealy S, Taylor SA, O'Brien SJ. Arthroscopic release of the long head of the biceps tendon: functional outcome and clinical results. The American journal of sports medicine. 2005;33(2):208-13
  • Referans16. Kim J, Nam JH, Kim Y, Kim JS, Kim SH. Long Head of the Biceps Tendon Tenotomy versus Subpectoral Tenodesis in Rotator Cuff Repair. Clinics in orthopedic surgery. 2020;12(3):371-8
  • Referans17. Koh KH, Ahn JH, Kim SM, Yoo JC. Treatment of biceps tendon lesions in the setting of rotator cuff tears: prospective cohort study of tenotomy versus tenodesis. The American journal of sports medicine. 2010;38(8):1584-90
  • Referans18. MacDonald P, Verhulst F, McRae S, Old J, Stranges G, Dubberley J, et al. 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. The American journal of sports medicine. 2020;48(6):1439-49
  • Referans19. Meier JO. [Rupture of biceps tendon after injection of steroid]. Ugeskrift for laeger. 1990;152(44):3258
  • Referans20. Meraner D, Sternberg C, Vega J, Hahne J, Kleine M, Leuzinger J. Arthroscopic tenodesis versus tenotomy of the long head of biceps tendon in simultaneous rotator cuff repair. Archives of orthopaedic and trauma surgery. 2016;136(1):101-6
  • Referans21. Murthi AM, Vosburgh CL, Neviaser TJ. The incidence of pathologic changes of the long head of the biceps tendon. Journal of shoulder and elbow surgery. 2000;9(5):382-5
  • Referans22. Ong SG. Spontaneous biceps tendon rupture in a patient with mixed connective tissue disease. Malaysian family physician : the official journal of the Academy of Family Physicians of Malaysia. 2013;8(3):31-3
  • Referans23. Pantazis K, Roupas ND, Panagopoulos A, Theodoraki S, Tsintoni A, Kyriazopoulou V. Spontaneous rupture of the long head of the biceps tendon in a woman with hypothyroidism: a case report. Journal of medical case reports. 2016;10:2
  • Referans24. Redondo-Alonso L, Chamorro-Moriana G, Jiménez-Rejano JJ, López-Tarrida P, Ridao-Fernández C. Relationship between chronic pathologies of the supraspinatus tendon and the long head of the biceps tendon: systematic review. BMC musculoskeletal disorders. 2014;15:377
  • Referans25. Refior HJ, Sowa D. Long tendon of the biceps brachii: sites of predilection for degenerative lesions. Journal of shoulder and elbow surgery. 1995;4(6):436-40
  • Referans26. Resch H, Breitfuss H. [Spontaneous tendon ruptures. Etiology, pathogenesis and therapy]. Der Orthopade. 1995;24(3):209-19
  • Referans27. Sethi N, Wright R, Yamaguchi K. Disorders of the long head of the biceps tendon. Journal of shoulder and elbow surgery. 1999;8(6):644-54
  • Referans28. Slenker NR, Lawson K, Ciccotti MG, Dodson CC, Cohen SB. Biceps tenotomy versus tenodesis: clinical outcomes. Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. 2012;28(4):576-82
  • Referans29. Zhang Q, Zhou J, Ge H, Cheng B. Tenotomy or tenodesis for long head biceps lesions in shoulders with reparable rotator cuff tears: a prospective randomised trial. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. 2015;23(2):464-9
Year 2022, Volume: 39 Issue: 3, 728 - 732, 30.08.2022

Abstract

References

  • Referans1. Beall DP, Williamson EE, Ly JQ, Adkins MC, Emery RL, Jones TP, et al. Association of biceps tendon tears with rotator cuff abnormalities: degree of correlation with tears of the anterior and superior portions of the rotator cuff. AJR American journal of roentgenology. 2003;180(3):633-9
  • Referans2. Belay ES, Wittstein JR, Garrigues GE, Lassiter TE, Scribani M, Goldner RD, et al. Biceps tenotomy has earlier pain relief compared to biceps tenodesis: a randomized prospective study. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. 2019;27(12):4032-7
  • Referans3. Boileau P, Baqué F, Valerio L, Ahrens P, Chuinard C, Trojani C. Isolated arthroscopic biceps tenotomy or tenodesis improves symptoms in patients with massive irreparable rotator cuff tears. The Journal of bone and joint surgery American volume. 2007;89(4):747-57
  • Referans4. Braun S, Horan MP, Elser F, Millett PJ. Lesions of the biceps pulley. The American journal of sports medicine. 2011;39(4):790-5
  • Referans5. Carter AN, Erickson SM. Proximal biceps tendon rupture: primarily an injury of middle age. The Physician and sportsmedicine. 1999;27(6):95-101
  • Referans6. Castricini R, Familiari F, De Gori M, Riccelli DA, De Benedetto M, Orlando N, et al. Tenodesis is not superior to tenotomy in the treatment of the long head of biceps tendon lesions. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. 2018;26(1):169-75
  • Referans7. Chen CH, Hsu KY, Chen WJ, Shih CH. Incidence and severity of biceps long head tendon lesion in patients with complete rotator cuff tears. The Journal of trauma. 2005;58(6):1189-93
  • Referans8. De Carli A, Vadalà A, Zanzotto E, Zampar G, Vetrano M, Iorio R, et al. Reparable rotator cuff tears with concomitant long-head biceps lesions: tenotomy or tenotomy/tenodesis? Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. 2012;20(12):2553-8
  • Referans9. Franceschi F, Longo UG, Ruzzini L, Papalia R, Rizzello G, Denaro V. To detach the long head of the biceps tendon after tenodesis or not: outcome analysis at the 4-year follow-up of two different techniques. International orthopaedics. 2007;31(4):537-45
  • Referans10. Friedman JL, FitzPatrick JL, Rylander LS, Bennett C, Vidal AF, McCarty EC. Biceps Tenotomy Versus Tenodesis in Active Patients Younger Than 55 Years: Is There a Difference in Strength and Outcomes? Orthopaedic journal of sports medicine. 2015;3(2):2325967115570848
  • Referans11. Frost A, Zafar MS, Maffulli N. Tenotomy versus tenodesis in the management of pathologic lesions of the tendon of the long head of the biceps brachii. The American journal of sports medicine. 2009;37(4):828-33
  • Referans12. Gill TJ, McIrvin E, Mair SD, Hawkins RJ. Results of biceps tenotomy for treatment of pathology of the long head of the biceps brachii. Journal of shoulder and elbow surgery. 2001;10(3):247-9
  • Referans13. Habermeyer P, Walch G. The biceps tendon and rotator cuff disease. In: Burkhead WZ Jr, ed. Rotator Cuff Disorders. Media, PA: Williams & Wilkins; 1996:142.
  • Referans14. Hufeland M, Wicke S, Verde PE, Krauspe R, Patzer T. Biceps tenodesis versus tenotomy in isolated LHB lesions: a prospective randomized clinical trial. Archives of orthopaedic and trauma surgery. 2019;139(7):961-70
  • Referans15. Kelly AM, Drakos MC, Fealy S, Taylor SA, O'Brien SJ. Arthroscopic release of the long head of the biceps tendon: functional outcome and clinical results. The American journal of sports medicine. 2005;33(2):208-13
  • Referans16. Kim J, Nam JH, Kim Y, Kim JS, Kim SH. Long Head of the Biceps Tendon Tenotomy versus Subpectoral Tenodesis in Rotator Cuff Repair. Clinics in orthopedic surgery. 2020;12(3):371-8
  • Referans17. Koh KH, Ahn JH, Kim SM, Yoo JC. Treatment of biceps tendon lesions in the setting of rotator cuff tears: prospective cohort study of tenotomy versus tenodesis. The American journal of sports medicine. 2010;38(8):1584-90
  • Referans18. MacDonald P, Verhulst F, McRae S, Old J, Stranges G, Dubberley J, et al. 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. The American journal of sports medicine. 2020;48(6):1439-49
  • Referans19. Meier JO. [Rupture of biceps tendon after injection of steroid]. Ugeskrift for laeger. 1990;152(44):3258
  • Referans20. Meraner D, Sternberg C, Vega J, Hahne J, Kleine M, Leuzinger J. Arthroscopic tenodesis versus tenotomy of the long head of biceps tendon in simultaneous rotator cuff repair. Archives of orthopaedic and trauma surgery. 2016;136(1):101-6
  • Referans21. Murthi AM, Vosburgh CL, Neviaser TJ. The incidence of pathologic changes of the long head of the biceps tendon. Journal of shoulder and elbow surgery. 2000;9(5):382-5
  • Referans22. Ong SG. Spontaneous biceps tendon rupture in a patient with mixed connective tissue disease. Malaysian family physician : the official journal of the Academy of Family Physicians of Malaysia. 2013;8(3):31-3
  • Referans23. Pantazis K, Roupas ND, Panagopoulos A, Theodoraki S, Tsintoni A, Kyriazopoulou V. Spontaneous rupture of the long head of the biceps tendon in a woman with hypothyroidism: a case report. Journal of medical case reports. 2016;10:2
  • Referans24. Redondo-Alonso L, Chamorro-Moriana G, Jiménez-Rejano JJ, López-Tarrida P, Ridao-Fernández C. Relationship between chronic pathologies of the supraspinatus tendon and the long head of the biceps tendon: systematic review. BMC musculoskeletal disorders. 2014;15:377
  • Referans25. Refior HJ, Sowa D. Long tendon of the biceps brachii: sites of predilection for degenerative lesions. Journal of shoulder and elbow surgery. 1995;4(6):436-40
  • Referans26. Resch H, Breitfuss H. [Spontaneous tendon ruptures. Etiology, pathogenesis and therapy]. Der Orthopade. 1995;24(3):209-19
  • Referans27. Sethi N, Wright R, Yamaguchi K. Disorders of the long head of the biceps tendon. Journal of shoulder and elbow surgery. 1999;8(6):644-54
  • Referans28. Slenker NR, Lawson K, Ciccotti MG, Dodson CC, Cohen SB. Biceps tenotomy versus tenodesis: clinical outcomes. Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. 2012;28(4):576-82
  • Referans29. Zhang Q, Zhou J, Ge H, Cheng B. Tenotomy or tenodesis for long head biceps lesions in shoulders with reparable rotator cuff tears: a prospective randomised trial. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. 2015;23(2):464-9
There are 29 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Clinical Research
Authors

Fatih İlker Can 0000-0001-5880-5336

Emre Gultac 0000-0003-1943-2199

Cem Yalın Kılınç 0000-0003-2568-0500

İsmail Gökhan Şahin 0000-0002-6274-6102

Nevres Aydoğan 0000-0002-1837-2676

Early Pub Date August 30, 2022
Publication Date August 30, 2022
Submission Date February 8, 2022
Acceptance Date May 17, 2022
Published in Issue Year 2022 Volume: 39 Issue: 3

Cite

APA Can, F. İ., Gultac, E., Kılınç, C. Y., Şahin, İ. G., et al. (2022). Comparison of the Clinical Outcomes of Chronic Rupture, Arthroscopic Tenotomy and Tenodesis of Proximal Biceps Tendon. Journal of Experimental and Clinical Medicine, 39(3), 728-732.
AMA Can Fİ, Gultac E, Kılınç CY, Şahin İG, Aydoğan N. Comparison of the Clinical Outcomes of Chronic Rupture, Arthroscopic Tenotomy and Tenodesis of Proximal Biceps Tendon. J. Exp. Clin. Med. August 2022;39(3):728-732.
Chicago Can, Fatih İlker, Emre Gultac, Cem Yalın Kılınç, İsmail Gökhan Şahin, and Nevres Aydoğan. “Comparison of the Clinical Outcomes of Chronic Rupture, Arthroscopic Tenotomy and Tenodesis of Proximal Biceps Tendon”. Journal of Experimental and Clinical Medicine 39, no. 3 (August 2022): 728-32.
EndNote Can Fİ, Gultac E, Kılınç CY, Şahin İG, Aydoğan N (August 1, 2022) Comparison of the Clinical Outcomes of Chronic Rupture, Arthroscopic Tenotomy and Tenodesis of Proximal Biceps Tendon. Journal of Experimental and Clinical Medicine 39 3 728–732.
IEEE F. İ. Can, E. Gultac, C. Y. Kılınç, İ. G. Şahin, and N. Aydoğan, “Comparison of the Clinical Outcomes of Chronic Rupture, Arthroscopic Tenotomy and Tenodesis of Proximal Biceps Tendon”, J. Exp. Clin. Med., vol. 39, no. 3, pp. 728–732, 2022.
ISNAD Can, Fatih İlker et al. “Comparison of the Clinical Outcomes of Chronic Rupture, Arthroscopic Tenotomy and Tenodesis of Proximal Biceps Tendon”. Journal of Experimental and Clinical Medicine 39/3 (August 2022), 728-732.
JAMA Can Fİ, Gultac E, Kılınç CY, Şahin İG, Aydoğan N. Comparison of the Clinical Outcomes of Chronic Rupture, Arthroscopic Tenotomy and Tenodesis of Proximal Biceps Tendon. J. Exp. Clin. Med. 2022;39:728–732.
MLA Can, Fatih İlker et al. “Comparison of the Clinical Outcomes of Chronic Rupture, Arthroscopic Tenotomy and Tenodesis of Proximal Biceps Tendon”. Journal of Experimental and Clinical Medicine, vol. 39, no. 3, 2022, pp. 728-32.
Vancouver Can Fİ, Gultac E, Kılınç CY, Şahin İG, Aydoğan N. Comparison of the Clinical Outcomes of Chronic Rupture, Arthroscopic Tenotomy and Tenodesis of Proximal Biceps Tendon. J. Exp. Clin. Med. 2022;39(3):728-32.