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Prospective Randomized Study of Arthroscopic Proximal vs Open Subpectoral Biceps Tenodesis: Is One Better?

OBJECTIVES: The biceps tendon is recognized as a significant source of pain in the shoulder for many patients. Operative techniques for tenodesis of the biceps tendon vary widely. No studies have been conducted directly comparing arthroscopic proximal vs. open subpectoral biceps tenodesis using a pr...

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Autores principales: Gobezie, Reuben, Shishani, Yousef, Flocken, Janice
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4968383/
http://dx.doi.org/10.1177/2325967116S00195
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author Gobezie, Reuben
Shishani, Yousef
Flocken, Janice
author_facet Gobezie, Reuben
Shishani, Yousef
Flocken, Janice
author_sort Gobezie, Reuben
collection PubMed
description OBJECTIVES: The biceps tendon is recognized as a significant source of pain in the shoulder for many patients. Operative techniques for tenodesis of the biceps tendon vary widely. No studies have been conducted directly comparing arthroscopic proximal vs. open subpectoral biceps tenodesis using a prospective study. We aim to compare the functional outcomes, pain relief, and complications of proximal vs. subpectoral biceps tenodesis. METHODS: A prospective randomized study of 129 consecutive patients requiring biceps tenodesis for treatment of biceps tendon tears, biceps instability or superior labral tears was performed. Clinical outcome measures used to conduct the study included active range of motion, VAS pain score, ASES score and SANE scores. Complications and revisions were also documented. RESULTS: Mean follow-up was 13.2 months (12-24 months) with 50 subpectoral tenodesis and 46 proximal tenodesis patients reaching minimum follow-up of 12 months. In the subpectoral group, the VAS improved from 5.7 to 2.0 (p < 0.001), ASES score improved from 49.8 to 77.7 (p< 0.001), and SANE scores improved from 42.1% to 77.7% (p<0.001). In the arthroscopic proximal tenodesis group, the VAS pain score improved from 5.9 to 1.8 (p<0.001), ASES score improved from 52.0 to 82.5 (p<0.001), and SANE scores improved from 42.8% to 78.6% (p<0.001). The revision rate for the subpectoral group was 4% (2/50 patients). The revision rate for the arthroscopic proximal tenodesis group was 8.6% (4/46). Twelve patients had persistent tenderness over the bicipital groove: 7 following proximal tenodesis and 5 following subpectoral tenodesis. No significant difference was found between methods in any outcome measures evaluated. CONCLUSION: This study found no difference in the functional outcomes or pain relief between proximal vs subpectoral biceps tenodesis. However, revision rates and occurrence of post-operative persistent bicipital groove pain for arthroscopic proximal tenodesis with internal fixation screw were slightly higher than in the subpectoral approach.
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spelling pubmed-49683832016-08-11 Prospective Randomized Study of Arthroscopic Proximal vs Open Subpectoral Biceps Tenodesis: Is One Better? Gobezie, Reuben Shishani, Yousef Flocken, Janice Orthop J Sports Med Article OBJECTIVES: The biceps tendon is recognized as a significant source of pain in the shoulder for many patients. Operative techniques for tenodesis of the biceps tendon vary widely. No studies have been conducted directly comparing arthroscopic proximal vs. open subpectoral biceps tenodesis using a prospective study. We aim to compare the functional outcomes, pain relief, and complications of proximal vs. subpectoral biceps tenodesis. METHODS: A prospective randomized study of 129 consecutive patients requiring biceps tenodesis for treatment of biceps tendon tears, biceps instability or superior labral tears was performed. Clinical outcome measures used to conduct the study included active range of motion, VAS pain score, ASES score and SANE scores. Complications and revisions were also documented. RESULTS: Mean follow-up was 13.2 months (12-24 months) with 50 subpectoral tenodesis and 46 proximal tenodesis patients reaching minimum follow-up of 12 months. In the subpectoral group, the VAS improved from 5.7 to 2.0 (p < 0.001), ASES score improved from 49.8 to 77.7 (p< 0.001), and SANE scores improved from 42.1% to 77.7% (p<0.001). In the arthroscopic proximal tenodesis group, the VAS pain score improved from 5.9 to 1.8 (p<0.001), ASES score improved from 52.0 to 82.5 (p<0.001), and SANE scores improved from 42.8% to 78.6% (p<0.001). The revision rate for the subpectoral group was 4% (2/50 patients). The revision rate for the arthroscopic proximal tenodesis group was 8.6% (4/46). Twelve patients had persistent tenderness over the bicipital groove: 7 following proximal tenodesis and 5 following subpectoral tenodesis. No significant difference was found between methods in any outcome measures evaluated. CONCLUSION: This study found no difference in the functional outcomes or pain relief between proximal vs subpectoral biceps tenodesis. However, revision rates and occurrence of post-operative persistent bicipital groove pain for arthroscopic proximal tenodesis with internal fixation screw were slightly higher than in the subpectoral approach. SAGE Publications 2016-07-29 /pmc/articles/PMC4968383/ http://dx.doi.org/10.1177/2325967116S00195 Text en © The Author(s) 2016 http://creativecommons.org/licenses/by-nc-nd/3.0/ This open-access article is published and distributed under the Creative Commons Attribution - NonCommercial - No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/), which permits the noncommercial use, distribution, and reproduction of the article in any medium, provided the original author and source are credited. You may not alter, transform, or build upon this article without the permission of the Author(s). For reprints and permission queries, please visit SAGE’s Web site at http://www.sagepub.com/journalsPermissions.nav.
spellingShingle Article
Gobezie, Reuben
Shishani, Yousef
Flocken, Janice
Prospective Randomized Study of Arthroscopic Proximal vs Open Subpectoral Biceps Tenodesis: Is One Better?
title Prospective Randomized Study of Arthroscopic Proximal vs Open Subpectoral Biceps Tenodesis: Is One Better?
title_full Prospective Randomized Study of Arthroscopic Proximal vs Open Subpectoral Biceps Tenodesis: Is One Better?
title_fullStr Prospective Randomized Study of Arthroscopic Proximal vs Open Subpectoral Biceps Tenodesis: Is One Better?
title_full_unstemmed Prospective Randomized Study of Arthroscopic Proximal vs Open Subpectoral Biceps Tenodesis: Is One Better?
title_short Prospective Randomized Study of Arthroscopic Proximal vs Open Subpectoral Biceps Tenodesis: Is One Better?
title_sort prospective randomized study of arthroscopic proximal vs open subpectoral biceps tenodesis: is one better?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4968383/
http://dx.doi.org/10.1177/2325967116S00195
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