Subpectoral Biceps Tenodesis For The Treatment Of Type Two And Four Slap Lesions

OBJECTIVES: Despite unsatisfactory outcomes in middle aged patients with SLAP lesions, surgical repair remains the gold standard for most Type II and Type IV SLAP lesions. Given recent data demonstrating higher SLAP repair failure rates in this subset of patients, biceps tenodesis may offer an excellent alternative. To our knowledge, only one study has investigated biceps tenodesis as an alternative to SLAP repair. This study investigates that subpectoral biceps tenodesis provides satisfactory outcomes for the treatment of Type II and Type IV SLAP lesions in middle aged patients. METHODS: Patients who were older than 18 years old and underwent subpectoral biceps tenodesis for isolated Type II or Type IV SLAP lesions by a single board certified shoulder surgeon from 2006-2012 were included. Exclusion criteria included those patients with Type II or Type IV SLAP lesions who underwent biceps tenodesis with rotator cuff repair, Bankart repair, or labral repair. Outcome measures included Visual Analog Pain Scale (VAS), American Shoulder and Elbow Surgeons Scores (ASES), and demographic data. RESULTS: Between 2006-2012, 33 patients underwent 36 subpectoral biceps tenodesis for isolated Type II or Type IV SLAP lesions by a single board certified shoulder surgeon. 26 patients with 29 shoulder surgeries consented to participate in the study. Average age was 46.7 years with 16 males and 10 females participating in the study. Average follow up was 29.3 months. A statistically significant improvement in ASES and VAS scores were found with an average of 48.1 and 6.4 preoperatively and an average of 87.5 and 1.5 post-operatively (p < .001). There was no statistically significant difference noted based on SLAP lesion type, age, activity level, or gender. 26 of 29 shoulders (89.65%) were able to return to their previous activity. CONCLUSION: Our study is able to confirm that biceps tenodesis results in statistically significant improvement in pain and functional outcomes for Type II and IV SLAP lesions. The results of biceps tenodesis for Type II and IV SLAP lesions is comparable to historical data. Based on these results, biceps tenodesis is a safe, effective, and technically straightforward alternative to SLAP repair in middle aged patients.