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Tenotomy or tenodesis for long head biceps lesions in shoulders with reparable rotator cuff tears: a prospective randomised trial

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Tenotomy and tenodesis are both effective for the treatment of long head biceps lesions. The aim of this study was to compare the clinical outcomes of the two procedures in patients older than 55 years of age affected by reparable rotator cuff tears with concomitant long head biceps pathologies.

Methods

Patients older than 55 years of age with long head biceps lesions and reparable rotator cuff tears were selected for this study. A total of 151 patients were randomly assigned to the tenotomy group (77 patients) or the tenodesis group (74 patients). Arthroscopic rotator cuff repair was performed in all the patients. Before surgery, physical and radiological examinations were performed; the constant score was measured as well. After the operation, the surgical time, cost, pain (VAS scores), Popeye sign, cramping pain, constant scores, satisfaction level and the elbow flexion and forearm supination strength indices were recorded.

Results

Patients were followed for an average of 24 months. No significant differences in the clinical results for the constant scores, the forearm supination and elbow flexion strength indices, Popeye sign, cramping pain and satisfaction level were found between the groups. However, tenotomy required a shorter surgical time (40.4 ± 4.0 vs. 50.4 ± 5.9 min, P < 0.001) and resulted in faster pain relief (3.1 ± 1.8 vs. 4.8 ± 1.9, P < 0.001).

Conclusion

Both tenotomy and tenodesis are effective and equal for the treatment of long head biceps lesions. However, because tenotomy requires a shorter surgical time and results in faster pain relief, tenotomy may be more suitable for the treatment of long head biceps lesions in patients older than 55 years of age with reparable rotator cuff tears.

Level of evidence

Therapeutic studies, Level I.

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Abbreviations

LHBT:

Long head of the biceps tendon

SLAP:

Superior labrum anterior–posterior

SI:

Strength index

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Acknowledgments

The authors thank Dr. Sun Yeqing and Yang Chunxi for the follow-up assessment.

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Authors and Affiliations

  1. Department of Orthopaedics, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, 301 Yanchang Middle Road, Shanghai, 200072, China

    Qiang Zhang, Jiaojiao Zhou, Heng’an Ge & Biao Cheng

  2. First Clinical Medical College, Nanjing Medical University, Nanjing, China

    Qiang Zhang, Jiaojiao Zhou & Heng’an Ge

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  1. Qiang Zhang
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  2. Jiaojiao Zhou
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Correspondence to Biao Cheng.

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Zhang, Q., Zhou, J., Ge, H. et al. Tenotomy or tenodesis for long head biceps lesions in shoulders with reparable rotator cuff tears: a prospective randomised trial. Knee Surg Sports Traumatol Arthrosc 23, 464–469 (2015). https://doi.org/10.1007/s00167-013-2587-8

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