2015 ISAKOS Biennial Congress ePoster #2206

Surgical Indications for Long Head Biceps Tenodesis: A Systematic Review

Michael Creech, MD, Hamilton CANADA
Marco Yeung, MD, Hamilton CANADA
Matthew Denkers, MD, Hamilton, ON CANADA
Nicole Simunovic, MSc, Hamilton, ON CANADA
George Athwal, MD, Hamilton, ON CANADA
Olufemi R. Ayeni, MD, PhD, MSc, FRCSC, Hamilton, ON CANADA

McMaster University, Hamilton, ON, CANADA

FDA Status Not Applicable

Summary: In this systematic review, the majority of the indications used in clinical studies on long head biceps tenodesis are inconsistent and poorly reported.

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Abstract:

Introduction

Tenodesis as a treatment for a symptomatic long head of biceps (LHB) tendon is becoming more prevalent and many new techniques exist, which are purported to make the procedure faster and more effective. The determination of appropriate surgical indications for the procedure will facilitate proper analysis and comparisons of the varied techniques. This review analyzes the reported indications in the literature in an attempt to guide future research and treatment.

Methods

A search of the EMBASE and MEDLINE databases was performed on November 1st, 2013 to identify clinically based articles published between the years of 1993 and2013 that reported indications for LHB tenodesis. Initially, 706 original articles were identified for analysis after duplicates were removed. After title and abstract searches, and full text reviews, the total number of articles selected in this systematic review was 39. Study information was recorded from each article including author, date of publication, number of patients, age of patients, follow-up period, procedure performed, indications for surgery, and study design. Two independent reviewers conducted a quality assessment of the included articles.

Results

In the 39 eligible clinical studies, the indications used were variable and often non-descriptive. The most common indications for a LHB tenodesis were partial tearing (51%), instability (49%), or tenosynovitis (44%), SLAP tear (28%), and a positive clinical exam for LHB pain (26%).

Conclusion

The majority of the indications used in clinical studies on LHB tenodesis are inconsistent and poorly reported. Despite this, the most common indications included LHB tearing, instability, tenosynovitis, clinical exam indicative of LHB pathology, SLAP tears and subjective shoulder pain. Rigorous reporting of indications,preoperative and operative findings should be emphasized in future studies, allowing surgeons to appropriately analyze outcomes of LHB tenodesis of different techniques within patient groups with distinct indications.