Comparison of labral repair and biceps tenodesis concomitant with arthroscopic rotator cuff repair in patients between the age of 40 and 60

Yıl 2022, Cilt: 5 Sayı: 2, 379 - 384, 15.03.2022

Bertan Cengiz , Sinan Oguzkaya

https://doi.org/10.32322/jhsm.1035458

Öz

Aim: Superior labrum anterior to posterior (SLAP) lesions are frequently accompanied by rotator cuff tear (RCT). The optimal treatment for type 2 and 4 SLAP lesions with RCT were not established. We aimed to compare the clinical results of SLAP repair and biceps tenodesis (BT) concomitant with arthroscopic rotator cuff repair (ARCR) in patients between 40 and 60 years old.
Material and Method: Forthy three patients (16 male, 27 females) who received ARCR concomitant with SLAP repair or BT for full-thickness rotator cuff tear were evaluated retrospectively. The patients were divided into the two groups based on treatment methods (SLAP repair, Group 1, 20 patients), (BT, Group 2, 23 patients). American Shoulder and Elbow Surgeons (ASES) score, University of California Los Angeles (UCLA) shoulder score, visual analogue scale scores (VASs), and range of motion (ROM) values were used as outcome tools.
Results: The mean age of the patients was 48.8±5.03 years. There was no difference in preoperative shoulder and pain scores (P<0.05). Postoperative 12th month and last follow-up ASES and UCLA scores and ROM measures were significantly higher in Group 2, but the minimally clinical important difference (MCID) was not reached in any of the shoulder scores.
Conclusion: In the patients between 40 and 60 years old, BT is associated with higher shoulder scores and ROM values than SLAP repair when performed with RCR, but the difference was clinically insignificant. We concluded that both BT and SLAP repair is suitable options with concomitant RCR.

Anahtar Kelimeler

SLAP repair, Biceps tenodesis, Middle age, Rotator cuff repair

Kaynakça

• Minagawa H, Yamamoto N, Abe H, et al. Prevalence of symptomatic and asymptomatic rotator cuff tears in the general population: From mass-screening in one village. J Orthop 2013; 10: 8-12.
• Plachel F, Siegert P, Rüttershoff K, et al. Long-term results of arthroscopic rotator cuff repair: a follow-up study comparing single-row versus double-row fixation techniques. Am J Sports Med 2020; 48: 1568-74.
• Hawi N, Liodakis E, Garving C, Habermeyer P, Tauber M. Pulley lesions in rotator cuff tears: prevalence, etiology, and concomitant pathologies. Arch Orthop Trauma Surg 2017; 137: 1097-105.
• De Carli A, Vadalà A, Zanzotto E, et. al. Reparable rotator cuff tears with concomitant long-head biceps lesions: tenotomy or tenotomy/tenodesis? Knee Surg Sports Traumatol Arthrosc 2012; 20: 2553-8.
• Oh JH, Lee YH, Kim SH, et. al. Comparison of treatments for superior labrum-biceps complex lesions with concomitant rotator cuff repair: a prospective, randomized, comparative analysis of debridement, biceps tenotomy, and biceps tenodesis. Arthroscopy 2016; 32: 958-67.
• Belay ES, Wittstein JR, Garrigues GE, et. al. Biceps tenotomy has earlier pain relief compared to biceps tenodesis: a randomized prospective study. Knee Surg Sports Traumatol Arthrosc 2019; 27: 4032-37.
• MacDonald P, Verhulst F, McRae S, 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. Am J Sports Med 2020; 48: 1439-49.
• Godenèche A, Kempf JF, Nové-Josserand L, et. al. Tenodesis renders better results than tenotomy in repairs of isolated supraspinatus tears with pathologic biceps. J Shoulder Elbow Surg 2018; 27: 1939-45.
• Franceschi F, Longo UG, Ruzzini L, Rizzello G, Maffulli N, Denaro V. No advantages in repairing a type II superior labrum anterior and posterior (SLAP) lesion when associated with rotator cuff repair in patients over age 50: a randomized controlled trial. Am J Sports Med 2008; 36: 247-53.
• Brockmeyer M, Tompkins M, Kohn DM, Lorbach O. SLAP lesions: a treatment algorithm. Knee Surg Sports Traumatol Arthrosc 2016; 24: 447-55.
• Panossian VR, Mihata T, Tibone JE, Fitzpatrick MJ, McGarry MH, Lee TQ. Biomechanical analysis of isolated type II SLAP lesions and repair. J Shoulder Elbow Surg 2005; 14: 529-34.
• Erickson BJ, Jain A, Abrams GD, et. al. SLAP lesions: trends in treatment. Arthroscopy 2016; 32: 976-81.
• Kim SJ, Lee IS, Kim SH, Woo CM, Chun YM. Arthroscopic repair of concomitant type II SLAP lesions in large to massive rotator cuff tears: comparison with biceps tenotomy. Am J Sports Med 2012; 40: 2786-93.
• Lim S, Kim SK, Kim YS. Comparison between SLAP repair and biceps tenodesis with concomitant rotator cuff repair in patients older than 45 years: minimum 2-year clinical and imaging outcomes. Clin Orthop Surg 2020; 12: 364-370
• Gilbert F, Böhm D, Eden L, et. al. Comparing the MRI-based Goutallier classification to an experimental quantitative MR spectroscopic fat measurement of the supraspinatus muscle. BMC Musculoskelet Disord 2016; 17: 355.
• DeOrio JK, Cofield RH. Results of a second attempt at surgical repair of a failed initial rotator-cuff repair. J Bone Joint Surg Am 1984; 66: 563-7.
• Park MC, Elattrache NS, Ahmad CS, Tibone JE. "Transosseous-equivalent" rotator cuff repair technique. Arthroscopy 2006; 22: 1360.e1-5.
• Tokish JM, Alexander TC, Kissenberth MJ, Hawkins RJ. Pseudoparalysis: a systematic review of term definitions, treatment approaches, and outcomes of management techniques. J Shoulder Elbow Surg 2017; 26: 177-87.
• Büyükdoğan K, Koyuncu Ö, Aslan L, Çelik D, Demirhan M. Translation, cross-cultural adaptation, reliability, and validity of Turkish version of the university of California Los Angeles (UCLA) shoulder scale into Turkish. Disabil Rehabil 2021: 1-8.
• Armstrong A. Diagnosis and clinical assessment of a stiff shoulder. Shoulder Elbow 2015; 7: 128-34.
• Forsythe B, Guss D, Anthony SG, Martin SD. Concomitant arthroscopic SLAP and rotator cuff repair. J Bone Joint Surg Am 2010; 92: 1362-9.
• Malavolta E, Yamamoto G, Bussius G, et. al. Establishing minimal clinically important difference for the UCLA and ASES scores after rotator cuff repair. Orthop Traumatol Surg Res 2021: 102894.
• Civan O, Bilsel K, Kapicioglu M, Ozenci AM. Repair versus biceps tenodesis for the slap tears: A systematic review. J Orthop Surg (Hong Kong) 2021; 29: 23094990211004794.
• Kanatli U, Ozturk BY, Bolukbasi S. Arthroscopic repair of type II superior labrum anterior posterior (SLAP) lesions in patients over the age of 45 years: a prospective study. Arch Orthop Trauma Surg 2011; 131: 1107-13.
• van Deurzen DFP, Garssen FL, Wessel RN, Kerkhoffs GMMJ, van den Bekerom MPJ, van Wier MF. The Popeye sign: a doctor's and not a patient's problem. J Shoulder Elbow Surg 2021; 30: 969-76.
• Lee HJ, Jeong JY, Kim CK, Kim YS. Surgical treatment of lesions of the long head of the biceps brachii tendon with rotator cuff tear: a prospective randomized clinical trial comparing the clinical results of tenotomy and tenodesis. J Shoulder Elbow Surg 2016; 25: 1107-14.
• Erickson J, Lavery K, Monica J, Gatt C, Dhawan A. Surgical treatment of symptomatic superior labrum anterior-posterior tears in patients older than 40 years: a systematic review. Am J Sports Med 2015; 43: 1274-82.