Skip to main content

Advertisement

Log in

Tenotomy or tenodesis for pathology of the long head of the biceps brachii: a systematic review and meta-analysis

  • Shoulder
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The objective of this meta-analysis is to compare clinical outcomes of tenotomy and tenodesis in the surgical treatment of long head of the biceps brachii (LHB).

Methods

A literature search was conducted in Embase and PubMed from 2000 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. We included nine studies comprising 650 patients undergoing LHB tenotomy or tenodesis, mostly with concomitant shoulder pathology.

Results

No significant difference in post-operative Constant score (mean difference 1.77), elbow flexion strength (mean difference 0), and forearm supination strength (mean difference 0.01) in favour of tenodesis was observed. A Popeye deformity (odds ratio 0.17) and cramping pain (odds ratio 0.38) in the bicipital groove muscle were less frequently seen in patients treated with tenodesis. The Coleman score ranged between 45 and 100 in the included studies.

Conclusion

Based on this meta-analysis, no differences in post-operative functional outcome between tenotomy and tenodesis for the treatment of LHB lesions were observed. A Popeye deformity and cramping pain in the bicipital groove are more frequently observed in patients treated with tenotomy.

Level of evidence

IV.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Boileau P, Baqué F, Valerio L, Ahrens P, Chuinard C, Trojani C (2007) Isolated arthroscopic biceps tenotomy or tenodesis improves symptoms in patients with massive irreparable rotator cuff tears. J Bone Joint Surg Am 89(4):747–757

    PubMed  Google Scholar 

  2. De Carli A, Vadalà A, Zanzotto E, Zampar G, Vetrano M, Iorio R, Ferretti A (2012) Reparable rotator cuff tears with concomitant long-head biceps lesions: tenotomy or tenotomy/tenodesis? Knee Surg Sports Traumatol Arthrosc 20(12):2553–2558

    Article  PubMed  Google Scholar 

  3. Carpenter JE, Flanagan CL, Thomopoulos S, Yian EH, Soslowsky LJ (1998) The effects of overuse combined with intrinsic or extrinsic alterations in an animal model of rotator cuff tendinosis. Am J Sports Med 26(6):801–807

    CAS  PubMed  Google Scholar 

  4. Coleman BD, Khan KM, Maffulli N, Cook JL, Wark JD (2000) Studies of surgical outcome after patellar tendinopathy: clinical significance of methodological deficiencies and guidelines for future studies. Victorian Institute of Sport Tendon Study Group. Scand J Med Sci Sports 10(1):2–11

    Article  CAS  PubMed  Google Scholar 

  5. Cho NS, Cha SW, Rhee YG (2014) Funnel tenotomy versus intracuff tenodesis for lesions of the long head of the biceps tendon associated with rotator cuff tears. Am J Sports Med 42(5):1161–1168

    Article  PubMed  Google Scholar 

  6. Creech MJ, Yeung M, Denkers M, Simunovic N, Athwal GS, Ayeni OR (2014) Surgical indications for long head biceps tenodesis: a systematic review. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-014-3383-9

    PubMed  Google Scholar 

  7. Delle Rose G, Borroni M, Silvestro A, Garofalo R, Conti M, De Nittis P, Castagna A (2012) The long head of biceps as a source of pain in active population: tenotomy or tenodesis? A comparison of 2 case series with isolated lesions. Musculoskelet Surg. 96(Suppl 1):S47–S52

    Article  PubMed  Google Scholar 

  8. Frost A, Zafar MS, Maffulli N (2009) Tenotomy versus tenodesis in the management of pathologic lesions of the tendon of the long head of the biceps brachii. Am J Sports Med 37(4):828–833

    Article  PubMed  Google Scholar 

  9. Gill TJ, McIrvin E, Mair SD, Hawkins RJ (2001) Results of biceps tenotomy for treatment of pathology of the long head of the biceps brachii. J Shoulder Elbow Surg 10(3):247–249

    Article  CAS  PubMed  Google Scholar 

  10. Koh KH, Ahn JH, Kim SM, Yoo JC (2010) Treatment of biceps tendon lesions in the setting of rotator cuff tears: prospective cohort study of tenotomy versus tenodesis. Am J Sports Med 38(8):1584–1590

    Article  PubMed  Google Scholar 

  11. Kumar VP, Satku K, Balasubramaniam P (1989) The role of the long head of biceps brachii in the stabilization of the head of the humerus. Clin Orthop Relat Res 244:172–175

    Google Scholar 

  12. Lemos D, Esquivel A, Duncan D, Marsh S, Lemos S (2013) Outlet biceps tenodesis: a new technique for treatment of biceps long head tendon injury. Arthrosc Tech 2(2):e83–e88

    Article  PubMed  PubMed Central  Google Scholar 

  13. Levy AS, Kelly BT, Lintner SA, Osbahr DC, Speer KP (2001) Function of the long head of the biceps at the shoulder: electromyographic analysis. J Shoulder Elbow Surg 10(3):250–255

    Article  CAS  PubMed  Google Scholar 

  14. Mariani EM, Cofield RH, Askew LJ, Li GP, Chao EY (1988) Rupture of the tendon of the long head of the biceps brachii. Surgical versus nonsurgical treatment. Clin Orthop Relat Res 228:233–239

    Google Scholar 

  15. Rodosky MW, Harner CD, Fu FH (1994) The role of the long head of the biceps muscle and superior glenoid labrum in anterior stability of the shoulder. Am J Sports Med 22(1):121–130

    Article  CAS  PubMed  Google Scholar 

  16. Scheibel M, Schröder RJ, Chen J, Bartsch M (2011) Arthroscopic soft tissue tenodesis versus bony fixation anchor tenodesis of the long head of the biceps tendon. Am J Sports Med 39(5):1046–1052

    Article  PubMed  Google Scholar 

  17. Sentürk I, Ozalay M, Akpınar S, Leblebici B, Cınar BM, Tuncay C (2011) Clinical and isokinetic comparison between tenotomy and tenodesis in biceps pathologies. Acta Orthop Traumatol Turc 45(1):41–46

    Article  PubMed  Google Scholar 

  18. Shank JR, Singleton SB, Braun S, Kissenberth MJ, Ramappa A, Ellis H, Decker MJ, Hawkins RJ, Torry MR (2011) A comparison of forearm supination and elbow flexion strength in patients with long head of the biceps tenotomy or tenodesis. Arthroscopy 27(1):9–16

    Article  PubMed  Google Scholar 

  19. Yamaguchi K, Riew KD, Galatz LM, Syme JA, Neviaser RJ (1997) Biceps activity during shoulder motion: an electromyographic analysis. Clin Orthop Relat Res 336:122–129

    Article  Google Scholar 

  20. Walch G, Edwards TB, Boulahia A, Nové-Josserand L, Neyton L, Szabo I (2005) Arthroscopic tenotomy of the long head of the biceps in the treatment of rotator cuff tears: clinical and radiographic results of 307 cases. J Shoulder Elbow Surg 14(3):238–246

    Article  PubMed  Google Scholar 

  21. Walter SD, Yao X (2007) Effect sizes can be calculated for studies reporting ranges for outcome variables in systematic reviews. J Clin Epidemiol 60(8):849–852

    Article  CAS  PubMed  Google Scholar 

  22. Warner JJ, McMahon PJ (1995) The role of the long head of the biceps brachii in superior stability of the glenohumeral joint. J Bone Joint Surg Am 77(3):366–372

    Article  CAS  PubMed  Google Scholar 

  23. Wittstein JR, Queen R, Abbey A, Toth A, Moorman CT (2011) Isokinetic strength, endurance, and subjective outcomes after biceps tenotomy versus tenodesis: a postoperative study. Am J Sports Med 39(4):857–865

    Article  PubMed  Google Scholar 

  24. Zhang Q, Zhou J, Ge H, Cheng B (2015) 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(2):464–469

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Navin Gurnani.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gurnani, N., van Deurzen, D.F.P., Janmaat, V.T. 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 24, 3765–3771 (2016). https://doi.org/10.1007/s00167-015-3640-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-015-3640-6

Keywords

Navigation