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Arthroscopic Versus Open Tenodesis: Which Patients Need Which?

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The Management of Biceps Pathology

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Abstract

The long head of the biceps tendon and the biceps-labral complex are common sources of shoulder pain and can be treated with a biceps tenodesis after failed nonoperative treatment. The tendon can be tenodesed either proximally by arthroscopic techniques or distally by open techniques. An arthroscopic tenodesis may be favored in the setting of adjunct arthroscopic shoulder procedures (thus avoiding the need for an additional incision), for cosmetic reasons, or when there is poor bone quality that would not be favorable for bony fixation, whether it is due to severely osteoporotic bone, tumor, bone cysts, or the presence of humeral implants. An open tenodesis may be favored in cases where the biceps pathology is further distal to that which can be addressed arthroscopically, such as tendon lesions or ruptures at or distal to the proximal edge of the pectoralis major, or persistent pain following a previous biceps tenotomy or tenodesis. Many of the indications for a biceps tenodesis however can be treated with either an arthroscopic or open approach, including SLAP lesions, partial LHBT tears, LHBT instability, or chronic tenosynovitis. Many studies have compared the outcomes following these two techniques but have not yet found any clinically significant differences between the two methods.

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Abbreviations

BLC:

biceps-labral complex

LHB:

long head of biceps

LHBT:

long head of the biceps tendon

SLAP:

superior labrum from anterior to posterior

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Authors and Affiliations

  1. Northwestern Memorial Hospital, Chicago, IL, USA

    Matthew J. Hartwell & Michael A. Terry

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  1. Matthew J. Hartwell
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  2. Michael A. Terry
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Editors and Affiliations

  1. Division of Sports Medicine, DuPage Medical Group, DuPage, IL, USA

    Anthony A. Romeo

  2. Division of Sports Medicine, Rothman Orthopaedic Institute, New York, NY, USA

    Brandon J. Erickson

  3. Eastern Virginia Medical School Surgery & Sports Medicine Jordan-Young Institute for Orthopaedic Surgery & Sports Medicine, Virginia Beach, VA, USA

    Justin W. Griffin

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Hartwell, M.J., Terry, M.A. (2021). Arthroscopic Versus Open Tenodesis: Which Patients Need Which?. In: Romeo, A.A., Erickson, B.J., Griffin, J.W. (eds) The Management of Biceps Pathology. Springer, Cham. https://doi.org/10.1007/978-3-030-63019-5_15

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  • DOI: https://doi.org/10.1007/978-3-030-63019-5_15

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