2015 ISAKOS Biennial Congress ePoster #2204

Tenotomy or Tenodesis for Pathology of the Long Head of the Biceps Brachii: A Systematic Review and Meta-Analysis

Navin Gurnani, MD, De Meern NETHERLANDS
Derek Van Deurzen, MD, Amsterdam NETHERLANDS
Vincent Janmaat, MD, Rotterdam NETHERLANDS
Michel Van Den Bekerom, MD, Amsterdam NETHERLANDS

Onze Lieve Vrouwe Gasthuis, Amsterdam, Noord Holland, NETHERLANDS

FDA Status Cleared

Summary: Surgical treatment with Tenotomy or Tenodesis of Long Head Biceps Brachii Pathology do not differ in functional outcome.

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Abstract:

Introduction

Pathology of the Long head of the Biceps Brachii (LHB) is a well-know cause of shoulder pain, mostly associated with pathology of the rotator cuff. The best surgical treatment still remains under debate. The objective of this meta-analysis is to compare clinical outcomes of tenotomy versus tenodesis in the surgical treatment of LHB.

Methods

A literature search was conducted in EMBASE en PUMBED from 1982 to April 2014. All studies comparing the clinical outcomes between LHB tenotomy and tenodesis were included. The quality assessment was done by utilizing the Coleman score.

Results

We included 9 studies comprising of 650 patients undergoing LHB tenotomy or tenodesis, mostly with concomitant shoulder pathology. No significant difference in postoperative Constant Score (mean difference 1.70), elbow flexion strength (mean difference 0) and forearm supination strength (mean difference 0.01) in favor of tenodesis was observed. A Popeye deformity was less frequently seen in patients treated with tenodesis (Odds ratio 0.17). The Coleman score ranged between 45-100 in the included studies.

Conclusion

Based on this meta-analysis no differences in postoperative functional outcome between tenotomy and tenodesis for the treatment of LBH lesions were observed. A Popeye deformity is more frequently observed in patients treated with tenotomy.