Effectiveness comparison of arthroscopic intertubercular groove and open subpectoral tenodesis for long head of biceps tendon tendinopathy_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

XIANG Xianxiang ¹ , LIU Yupeng ¹ , CHEN Rongjin ² , LIU Yu ¹ , GONG Jue ³ , LI Danmei ⁴ ,  WANG Weiming ³

1. Department of Sports Medicine, Affiliated Zhongshan Hospital of Dalian University, Dalian Liaoning, 116001, P.R.China;
2. Department of Orthopedics, Affiliated Rehabilitation Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu Sichuan, 611130, P.R.China;
3. Department of Sports Medicine, Affiliated Xinhua Hospital of Dalian University, Dalian Liaoning, 116021, P.R.China;
4. Department of Orthopedics, Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Province Orthopedic Hospital), Luoyang Henan, 471000, P.R.China;

Corresponding author：

WANG Weiming, Email: oldpal@126.com

Keywords：

Long head of biceps tendon; rotator cuff injury; tendinopathy; tenodesis; arthroscopy

DOI：

10.7507/1002-1892.202103223

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Objective To compare the effectiveness of arthroscopic intertubercular groove and open subpectoral tenodesis in treatment of long head of biceps tendon (LHBT) tendinopathy.Methods A clinical data of 80 patients with LHBT tendinopathy who were admitted between June 2013 and May 2017 and met the selection criteria was retrospectively analyzed. After cutting LHBT under arthroscopy, the arthroscopic intertubercular groove tenodesis was performed in 40 cases (group A) and open subpectoral tenodesis was performed in 40 cases (group B). There was no significant difference in the gender, age, side of the affected shoulder joint, disease duration, and preoperative pain visual analogue scale (VAS) score, Constant score, American Society of Shoulder and Elbow Surgery (ASES) score, Disability of Arm, Shoulder, and Hand (DASH) score, LHBT score (LHBS) between the two groups (P>0.05). The operation time and the scores of shoulder joint pain and function at 12 months after operation were compared between the two groups.Results The operation time was (3.6±2.5) minutes in group A and (8.5±2.3) minutes in group B, showing a significant difference (t=18.584, P=0.000). The incisions of the two groups healed by first intention, and there was no complication such as infection or thrombosis. All patients were followed up. The follow-up time was 24-30 months (mean, 26.0 months) in group A and 24-31 months (mean, 26.0 months) in group B. Both Speed test and Yergason test were negative at 3 months after operation. MRI showed that there was no obvious effusion around the LHTB and no dislocation of LHTB. At 12 months after operation, the VAS score, Constant score, ASES score, DASH score, and LHBS score of the two groups all improved when compared with preoperative ones (P<0.05), and there was no significant difference in the differences before and after operation between the two groups (P>0.05). No Popeye sign appeared during the follow-up.Conclusion The arthroscopic intertubercular groove and open subpectoral tenodesis can effectively relieve shoulder pain and improve function, but the former has shorter operation time and less trauma.

Citation： XIANG Xianxiang, LIU Yupeng, CHEN Rongjin, LIU Yu, GONG Jue, LI Danmei, WANG Weiming. Effectiveness comparison of arthroscopic intertubercular groove and open subpectoral tenodesis for long head of biceps tendon tendinopathy. Chinese Journal of Reparative and Reconstructive Surgery, 2021, 35(10): 1293-1297. doi: 10.7507/1002-1892.202103223 Copy

1.	Castricini R, Familiari F, De Gori M, et al. Tenodesis is not superior to tenotomy in the treatment of the long head of biceps tendon lesions. Knee Surg Sports Traumatol Arthrosc, 2018, 26(1): 169-175.
2.	Meeks BD, Meeks NM, Froehle AW, et al. Patient satisfaction after biceps tenotomy. Orthop J Sports Med, 2017, 5(5): 2325967117707737. doi: 10.1177/2325967117707737.
3.	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. Am J Sports Med, 2009, 37(4): 828-833.
4.	Gurnani N, van Deurzen DF, Janmaat VT, et al. Tenotomy or tenodesis for pathology of the long head of the biceps brachii: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc, 2016, 24(12): 3765-3771.
5.	Leroux T, Chahal J, Wasserstein D, et al. A systematic review and meta-analysis comparing clinical outcomes after concurrent rotator cuff repair and long head biceps tenodesis or tenotomy. Sports Health, 2015, 7(4): 303-307.
6.	Scheibel M, Schröder RJ, Chen J, et al. Arthroscopic soft tissue tenodesis versus bony fixation anchor tenodesis of the long head of the biceps tendon. Am J Sports Med, 2011, 39(5): 1046-1052.
7.	李丹妹, 王卫明, 马霄君, 等. 后伸牵拉试验——一种诊断肱二头肌长头腱及滑车系统损伤敏感的新试验. 中国运动医学杂志, 2019, 38(5): 347-352.
8.	Malavolta EA, Assunção JH, Guglielmetti CL, et al. Accuracy of preoperative MRI in the diagnosis of disorders of the long head of the biceps tendon. Eur J Radiol, 2015, 84(11): 2250-2254.
9.	Kim JY, Rhee SM, Rhee YG, et al. 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(1): 270. doi: 10.1186/s12891-019-2654-5.
10.	Baptista E, Malavolta EA, Gracitelli MEC, et al. Diagnostic accuracy of MRI for detection of tears and instability of proximal long head of biceps tendon: an evaluation of 100 shoulders compared with arthroscopy. Skeletal Radiol, 2019, 48(11): 1723-1733.
11.	Battaglia PJ, Welk AB, Kettner NW, et al. Ultrasound appearance and dynamic evaluation of variant long head of the biceps tendon anatomy with MRI correlation. Ultrasound, 2014, 18(2): 187-189.
12.	Belay ES, Wittstein JR, Garrigues GE. Biceps tenotomy has earlier pain relief compared to biceps tenodesis: a randomized prospective study. Knee Surg Sports Traumatol Arthrosc, 2019, 27(12): 4032-4037.
13.	Hong CK, Chang CH, Hsu KL, et al. Patients older than 55 years prefer biceps tenodesis over tenotomy to the same degree as young patients. Journal of Orthopaedic Science, 2020, 25(3): 416-422.
14.	Boileau P, Parratte S, Chuinard C, et al. Arthroscopic treatment of isolated type Ⅱ SLAP lesions: biceps tenodesis as an alternative to reinsertion. Am J Sports Med, 2009, 37(5): 929-936.
15.	Ge H, Zhang Q, Sun Y, et al. Tenotomy or tenodesis for the long head of biceps lesions in shoulders: a systematic review and meta-analysis. PLoS One, 2015, 10(3): e0121286. doi: 10.1371/journal.pone.0121286.
16.	McCrum CL, Alluri RK, Batech M, et al. Complications of biceps tenodesis based on location, fixation, and indication: a review of 1526 shoulders. Journal of Shoulder and Elbow Surgery, 2019, 28(3): 461-469.
17.	Mardani KM, Keyhani S, Ebrahim-Zadeh MH, et al. Rotator cuff tear with concomitant long head of biceps tendon (LHBT) degeneration: what is the preferred choice? Open subpectoral versus arthroscopic intraarticular tenodesis. J Orthop Traumatol, 2019, 20(1): 26. doi: 10.1186/s10195-019-0531-5.
18.	Frank RM, Bernardoni ED, Veera SS, et al. Biomechanical analysis of all-suture suture anchor fixation compared with conventional suture anchors and interference screws for biceps tenodesis. Arthroscopy, 2019, 35(6): 1760-1768.
19.	Sasaki Y, Ochiai N, Kenmoku T, et al. Arthroscopic tenodesis using a bioabsorbable interference screw and soft anchor: A case series of 60 patients. J Orthop Sci, 2020, 25(3): 410-415.
20.	Kerschbaum M, Weiss I, Mayr A, et al. The arthroscopic loop tenodesis procedure: An implant-free technique to treat long biceps tendon pathologies. Arthrosc Tech, 2019, 8(5): e503-e506.

1. Castricini R, Familiari F, De Gori M, et al. Tenodesis is not superior to tenotomy in the treatment of the long head of biceps tendon lesions. Knee Surg Sports Traumatol Arthrosc, 2018, 26(1): 169-175.
2. Meeks BD, Meeks NM, Froehle AW, et al. Patient satisfaction after biceps tenotomy. Orthop J Sports Med, 2017, 5(5): 2325967117707737. doi: 10.1177/2325967117707737.
3. 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. Am J Sports Med, 2009, 37(4): 828-833.
4. Gurnani N, van Deurzen DF, Janmaat VT, et al. Tenotomy or tenodesis for pathology of the long head of the biceps brachii: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc, 2016, 24(12): 3765-3771.
5. Leroux T, Chahal J, Wasserstein D, et al. A systematic review and meta-analysis comparing clinical outcomes after concurrent rotator cuff repair and long head biceps tenodesis or tenotomy. Sports Health, 2015, 7(4): 303-307.
6. Scheibel M, Schröder RJ, Chen J, et al. Arthroscopic soft tissue tenodesis versus bony fixation anchor tenodesis of the long head of the biceps tendon. Am J Sports Med, 2011, 39(5): 1046-1052.
7. 李丹妹, 王卫明, 马霄君, 等. 后伸牵拉试验——一种诊断肱二头肌长头腱及滑车系统损伤敏感的新试验. 中国运动医学杂志, 2019, 38(5): 347-352.
8. Malavolta EA, Assunção JH, Guglielmetti CL, et al. Accuracy of preoperative MRI in the diagnosis of disorders of the long head of the biceps tendon. Eur J Radiol, 2015, 84(11): 2250-2254.
9. Kim JY, Rhee SM, Rhee YG, et al. 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(1): 270. doi: 10.1186/s12891-019-2654-5.
10. Baptista E, Malavolta EA, Gracitelli MEC, et al. Diagnostic accuracy of MRI for detection of tears and instability of proximal long head of biceps tendon: an evaluation of 100 shoulders compared with arthroscopy. Skeletal Radiol, 2019, 48(11): 1723-1733.
11. Battaglia PJ, Welk AB, Kettner NW, et al. Ultrasound appearance and dynamic evaluation of variant long head of the biceps tendon anatomy with MRI correlation. Ultrasound, 2014, 18(2): 187-189.
12. Belay ES, Wittstein JR, Garrigues GE. Biceps tenotomy has earlier pain relief compared to biceps tenodesis: a randomized prospective study. Knee Surg Sports Traumatol Arthrosc, 2019, 27(12): 4032-4037.
13. Hong CK, Chang CH, Hsu KL, et al. Patients older than 55 years prefer biceps tenodesis over tenotomy to the same degree as young patients. Journal of Orthopaedic Science, 2020, 25(3): 416-422.
14. Boileau P, Parratte S, Chuinard C, et al. Arthroscopic treatment of isolated type Ⅱ SLAP lesions: biceps tenodesis as an alternative to reinsertion. Am J Sports Med, 2009, 37(5): 929-936.
15. Ge H, Zhang Q, Sun Y, et al. Tenotomy or tenodesis for the long head of biceps lesions in shoulders: a systematic review and meta-analysis. PLoS One, 2015, 10(3): e0121286. doi: 10.1371/journal.pone.0121286.
16. McCrum CL, Alluri RK, Batech M, et al. Complications of biceps tenodesis based on location, fixation, and indication: a review of 1526 shoulders. Journal of Shoulder and Elbow Surgery, 2019, 28(3): 461-469.
17. Mardani KM, Keyhani S, Ebrahim-Zadeh MH, et al. Rotator cuff tear with concomitant long head of biceps tendon (LHBT) degeneration: what is the preferred choice? Open subpectoral versus arthroscopic intraarticular tenodesis. J Orthop Traumatol, 2019, 20(1): 26. doi: 10.1186/s10195-019-0531-5.
18. Frank RM, Bernardoni ED, Veera SS, et al. Biomechanical analysis of all-suture suture anchor fixation compared with conventional suture anchors and interference screws for biceps tenodesis. Arthroscopy, 2019, 35(6): 1760-1768.
19. Sasaki Y, Ochiai N, Kenmoku T, et al. Arthroscopic tenodesis using a bioabsorbable interference screw and soft anchor: A case series of 60 patients. J Orthop Sci, 2020, 25(3): 410-415.
20. Kerschbaum M, Weiss I, Mayr A, et al. The arthroscopic loop tenodesis procedure: An implant-free technique to treat long biceps tendon pathologies. Arthrosc Tech, 2019, 8(5): e503-e506.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness comparison of arthroscopic intertubercular groove and open subpectoral tenodesis for long head of biceps tendon tendinopathy

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