Comparison of Functional Outcomes Between Arthroscopic and Open Tenodesis in the Management of Biceps Long Head Tendonitis

Mohammed Hatem Salal Al-Sabti; Majed Aswad Al-Saad; Osama Luay Al-Samaraee

doi:10.54133/ajms.v9i2.2307

Authors

Mohammed Hatem Salal Al-Sabti Department of Surgery, College of Medicine, University of Baghdad, Baghdad, Iraq https://orcid.org/0009-0007-4808-5962
Majed Aswad Al-Saad Baghdad Teaching Hospital, Medical City, Baghdad, Iraq https://orcid.org/0009-0006-9969-8729
Osama Luay Al-Samaraee Baghdad Teaching Hospital, Medical City, Baghdad, Iraq https://orcid.org/0009-0006-4171-8926

DOI:

https://doi.org/10.54133/ajms.v9i2.2307

Keywords:

Arthroscopy, Shoulder pain, Tendonitis, Tenodesis

Abstract

Background: Arthroscopic suprapectoral biceps tenodesis (ABT) and open subpectoral biceps tenodesis (OBT) are utilized for treating long head biceps tendon (LHBT) pathology. The clinical advantage of one approach over the other is not well characterized. Objective: To compare arthroscopic tenodesis and open subcortical techniques concerning their functional outcome. Methods: The study included 20 patients aged 20-40 years with long head biceps tendonitis not responding to conservative management. They were randomly allocated into two groups of 10 each. Group 1 received open tenodesis, and group 2 received arthroscopic tenodesis. The outcome was measured, and each case was followed for 1 year based on the American Shoulder and Elbow Surgeons scoring system. Results: The mean ASES score of the open group at 3-month post-operation was 86.7, which did not significantly differ from that of the arthroscopic group (89.5). The mean score 6 months post-operation in the open group was 90.1, which was also not significantly different compared to the arthroscopic group (89.5). Meanwhile, the mean score of the open group after 1 year was 91.1, which was not significantly different from that of the arthroscopic group (91.3). Conclusions: Patients undergoing both procedures experienced similar improvement in the clinical outcomes, without differences regarding treatment failure and functional performance. The arthroscopic group showed increased incidence of residual pain in the early postoperative period.

Downloads

Download data is not yet available.

References

Can F, Gültaç E, Şahin İ G, Kılınç CY, Hürriyet Aydoğan N. Subacromial impingement as a predictor of proximal biceps tendon disorders. J Dis Relat Surg. 2022;33:142-148. doi: 10.52312/jdrs.2022.499. DOI: https://doi.org/10.52312/jdrs.2022.499

Kim JY, Rhee SM, Rhee YG. Accuracy of MRI in diagnosing intra-articular pathology of the long head of the biceps tendon: results with a large cohort of patients. BMC Musculoskelet Disord. 2019;20:270. doi: 10.1186/s12891-019-2654-5. DOI: https://doi.org/10.1186/s12891-019-2654-5

Almeida GG, Graf N, Wildermuth S, Fischer T, Waelti S, Jacxsens M, et al. Diagnostic performance of long head of biceps tendon tears on MRI: systematic review and meta-analysis. Eur Radiol. 2024;34:4309-4320. doi: 10.1007/s00330-023-10521-6. DOI: https://doi.org/10.1007/s00330-023-10521-6

McDevitt AW, Cleland JA, Addison S, Calderon L, Snodgrass S. Physical therapy interventions for the management of biceps tendinopathy: An international Delphi Study. Int J Sports Phys Ther. 2022;17:677-694. doi: 10.26603/001c.35256. DOI: https://doi.org/10.26603/001c.35256

Lalehzarian SP, Agarwalla A, Liu JN. Management of proximal biceps tendon pathology. World J Orthop. 2022;13:36-57. doi: 10.5312/wjo.v13.i1.36. DOI: https://doi.org/10.5312/wjo.v13.i1.36

McCrum CL, Alluri RK, Batech M, Mirzayan R. Complications of biceps tenodesis based on location, fixation, and indication: a review of 1526 shoulders. J Shoulder Elbow Surg. 2019;28:461-469. doi: 10.1016/j.jse.2018.09.005. DOI: https://doi.org/10.1016/j.jse.2018.09.005

Sallay PI, Reed L. The measurement of normative American Shoulder and Elbow Surgeons scores. J Shoulder Elbow Surg. 2003;12:622-7. doi: 10.1016/s1058-2746(03)00209-x. DOI: https://doi.org/10.1016/S1058-2746(03)00209-X

Duchman KR, DeMik DE, Uribe B, Wolf BR, Bollier M. Open versus arthroscopic biceps tenodesis: A comparison of functional outcomes. Iowa Orthop J. 2016;36:79-87.

Green JM, Getelman MH, Snyder SJ, Burns JP. All-Arthroscopic suprapectoral versus open subpectoral tenodesis of the long head of the biceps brachii without the use of interference screws. Arthroscopy. 2017;33:19-25. doi: 10.1016/j.arthro.2016.07.007. DOI: https://doi.org/10.1016/j.arthro.2016.07.007

Deng ZJ, Yin C, Cusano J, Abdul-Rassoul H, Curry EJ, Novikov D, et al. Outcomes and complications after primary arthroscopic suprapectoral versus open subpectoral biceps tenodesis for superior labral anterior-posterior tears or biceps abnormalities: A systematic review and meta-analysis. Orthop J Sports Med. 2020;8:2325967120945322. doi: 10.1177/2325967120945322. DOI: https://doi.org/10.1177/2325967120945322

van Deurzen DFP, Gurnani N, Alta TDW, Willems JH, Onstenk R, van den Bekerom MPJ. Suprapectoral versus subpectoral tenodesis for Long Head Biceps Brachii tendinopathy: A systematic review and meta-analysis. Orthop Traumatol Surg Res. 2020;106:693-700. doi: 10.1016/j.otsr.2020.01.004. DOI: https://doi.org/10.1016/j.otsr.2020.01.004

Belk JW, Thon SG, Hart J, McCarty EC, McCarty EC. Subpectoral versus suprapectoral biceps tenodesis yields similar clinical outcomes: a systematic review. J Isakos. 2021;6:356-362. doi: 10.1136/jisakos-2020-000543. DOI: https://doi.org/10.1136/jisakos-2020-000543

Gombera MM, Kahlenberg CA, Nair R, Saltzman MD, Terry MA. All-arthroscopic suprapectoral versus open subpectoral tenodesis of the long head of the biceps brachii. Am J Sports Med. 2015;43:1077-1083. doi: 10.1177/0363546515570024. DOI: https://doi.org/10.1177/0363546515570024

Taylor SA, Khair MM, Gulotta LV, Pearle AD, Baret NJ, Newman AM, et al. Diagnostic glenohumeral arthroscopy fails to fully evaluate the biceps-labral complex. Arthroscopy. 2015;31:215-224. doi: 10.1016/j.arthro.2014.10.017. DOI: https://doi.org/10.1016/j.arthro.2014.10.017

Clinker C, Simister SK, Thomas L, Da Silva A, Ishikawa H, Joyce C, et al. Revision subpectoral biceps tenodesis demonstrates a high patient satisfaction and good functional outcomes. Arthrosc Sports Med Rehabil. 2023;5:100797. doi: 10.1016/j.asmr.2023.100797. DOI: https://doi.org/10.1016/j.asmr.2023.100797

Hassan S, Patel V. Biceps tenodesis versus biceps tenotomy for biceps tendinitis without rotator cuff tears. J Clin Orthop Trauma. 2019;10:248-256. doi: 10.1016/j.jcot.2018.12.013. DOI: https://doi.org/10.1016/j.jcot.2018.12.013