Treatment of long head of biceps tendon lesions together with rotator cuff tears: which method is preferred? Tenotomy or Tenodesis
ESSKA Academy. Mardani-kivi M. May 9, 2018; 209924; P22-596
Mohsen Mardani-kivi
Mohsen Mardani-kivi
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Objectives: Long head of biceps tendon (LHBT) lesions are associated with rotator cuff tears and in large tears surgery is the treatment of choice. Here, we aimed to evaluate outcomes of tenotomy and tenodesis in such cases.

Methods: In this randomized clinical trial (registration code: IRCT201406117274N10), patients aged 45-60 years who were candidates for arthroscopic treatment of rotator cuff tears with at least one positive biceps test before surgery were enrolled. Patients were allocated in tenotomy or tenodesis groups using random block. Therapeutic outcomes were investigated by evaluation of occurrence of Popeye deformity, patient's satisfaction based on visual analog scale (VAS), shoulder function according to the Constant score and simple shoulder test (SST) and pain intensity based on numerical rating scale (NRS) were measured before treatment and at 6 months, one and two years after operation. All data analyzed using SPSS software version 20.

Results: Both Popeye deformity and biceps brachii cramping were significantly higher in tenotomy group. Values of NRS, SST, VAS of patient's satisfaction, and Constant score significantly changed after operation as decrease in NRS and increase in all three others. However, only VAS of patient's satisfaction significantly differed between two groups just at 12 and 24 months post-operation. Only age, sex and dominance of involved limb had significant association with patient's satisfaction. Indeed, younger female patients with involvement of recessive limb had significant higher satisfaction (P<0.05).

Conclusions: Both methods produced good clinical outcomes. Although patient satisfaction was higher in tenodesis group, no significant differences existed in functional outcomes.

Long head of biceps tendon lesions; Rotator cuff tears; Tenodesis; Tenotomy; Surgical method; Tendon lesions
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