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European Journal of Orthopaedic Surgery & Traumatology

Erschienen in:

01.01.2016 | Original Article • SHOULDER - ARTHROSCOPY

Biceps tenodesis (long head): arthroscopic keyhole technique versus arthroscopic interference screw: a prospective comparative clinical and radiographic marker study

verfasst von: Jean Kany, Régis Guinand, Pierre Croutzet, Rajkumar Amaravathi, Padmanaban Sekaran

Erschienen in: European Journal of Orthopaedic Surgery & Traumatology | Ausgabe 1/2016

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Abstract

Purpose

The long head biceps tenodesis (LHBT) is an alternative to tenotomy in order to prevent Popeye sign. Biomechanical studies showed that interference screw (IFS) was the strongest fixation but there might be complications and cost. What’s more, the analyses of tenodesis failures are undervalued because they only take visible deformations of the arm into account. The purpose of this study was to compare a modified arthroscopic “keyhole” LHBT (modified @KH) with an arthroscopic IFS LHBT (@IFS) using an objective method. We hypothesized that modified @KH gave similar clinical outcomes as @IFS without its hassles or drawbacks.

Methods

We present a 12-month prospective comparative study (modified @KH versus @IFS) performed by two experienced orthopedic surgeons. Modified @KH was performed on one hundred and nine patients versus @IFS that was performed on one hundred and two. A radiopaque marker was placed into the tendon. The review was conducted in the sixth month with clinical examination and plain standard X-ray to objectify the potential migration of the marker.

Results

Modified @KH showed 2.4 % visible deformity without any Popeye sign but 3.4 % radiographic metallic marker migrations. No complications were noted. @IFS showed 5.8 % visible deformity with 2.9 % Popeye sign and with 10.3 % radiographic metallic marker migrations; pain at tenodesis location was noted in 2 %. P value (0.13) indicates that there were no statistically significant differences.

Conclusion

We confirm the hypothesis that the modified @KH gives clinical and radiographic outcomes at least similar to @IFS without any complications and cost. The establishment of the radiopaque marker allows us to know the exact number of failures.

Level of evidence

Consecutive prospective comparative clinical, Level II-1 studies.

Boileau P, Ahrens P-M, Trojani C, Coste JS, Cordéro B, Rousseau P (2003) Entrapment of the long head of the biceps: the “hourglass biceps”. Another cause of pain and locking of the shoulder. Rev Chir Orthop 89(8):672–682PubMed

Boileau P, Baque F, Valerio L, Ahrens P, Chuinard C, Trojani C (2007) Isolated arthroscopic biceps tenotomy or tenodesis improves symptoms in patients with massive irreparable cuff tears. J Bone Joint Surg (Am) 89:747–757. doi:10.2106/jbjs.e.01097 CrossRef

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 14:238–246. doi:10.1016/j.jse.2004.07.008 PubMedCrossRef

Kelly AM, Drakos MC, Fealy S, Taylor SA, O’Brien SJ (2005) Arthroscopic release of the long head of the biceps tendon: functional outcome and clinical results. Am J Sports Med 33:208–213. doi:10.1016/s0749-8063(03)00508-5 PubMedCrossRef

Boileau P, Krishnan SG, Coste JS, Walch G (2002) Arthroscopic biceps tenodesis: a new technique using bio-absorbable interference screw fixation. Arthroscopy 18:1002–1012. doi:10.1053/jars.2002.36488 PubMedCrossRef

Gartsman GM, Hammerman SM (2000) Arthroscopic biceps tenodesis: operative technique. Arthroscopy 16:550–552. doi:10.1053/jars.2000.4386 PubMedCrossRef

Richards DP, Burkhart SS, Lo IKY (2003) Arthroscopic biceps tenodesis with interference screw fixation: the lateral decubitus position. Oper Tech Sports Med 11:15–23. doi:10.1053/otsm.2003.35893 CrossRef

Mazzocca AD, Bicos J, Santangelo S, Romeo AA, Arciero RA (2005) The biomechanical evaluation of four fixation techniques for proximal biceps tenodesis. Arthroscopy 21:1296–1306. doi:10.1016/j.arthro.2005.08.008 PubMedCrossRef

Ozalay M, Akpinar S, Karaeminogullari O, Balcik C, Tasci A, Tandogan RN et al (2005) Mechanical strength of four different biceps tenodesis techniques. Arthroscopy 21:992–998. doi:10.1016/j.arthro.2005.05.002 PubMedCrossRef

10.

Lo IKY, Burkhart SS (2004) Arthroscopic biceps tenodesis using a bioabsorbable interference screw. Arthroscopy 20:85–95. doi:10.1016/j.arthro.2003.11.017 PubMedCrossRef

11.

Froimson AI, Oh I (1975) Keyhole tenodesis of biceps origin at the shoulder. Clin Orthop Relat Res 112:245–249PubMed

12.

Amaravati RS, Kany J, Guinand R, Saji MJ, Sekaran P (2011) Preliminary result of arthroscopic keyhole biceps tenodesis: a novel technique. Tech Shoulder Surg 12:25–31. doi:10.1097/bte.0b013e3182116be8 CrossRef

13.

Amaravathi RS, Pankappilly B, Kany J (2011) Arthroscopic keyhole proximal biceps tenodesis: a technical note. J Orthop Surg 19:379–383

14.

Kany J, Guinand R, Amaravathi RS, Alassaf I (2015) The keyhole technique for arthroscopic tenodesis of the long head of the biceps tendon. In vivo prospective study with a radio-opaque marker. Orthop Traumatol Surg Res 101:31–34. doi:10.1016/j.otsr.2014.10.016 PubMedCrossRef

15.

Romeo AA, Mazzocca AD, Tauro JC (2004) Arthroscopic biceps tenodesis. Arthroscopy 20:206–213. doi:10.1016/j.arthro.2003.11.033 PubMedCrossRef

16.

Kilicoglu O, Koyuncu O, Demirhan M, Esenyel CZ, Atalar AC, Ozsoy S et al (2005) Time-dependent changes in failure loads of 3 biceps tenodesis techniques: in vivo study in a sheep model. Am J Sports Med 33:1536–1544. doi:10.1177/0363546505274716 PubMedCrossRef

17.

Gombera MM, Kahlenberg CA, Nair R, Saltzman MD, Terry MA (2015) All-arthroscopic suprapectoral versus open subpectoral tenodesis of the long head of the biceps brachii. Am J Sports Med. doi:10.1177/0363546515570024 PubMed

18.

Hsu AR, Ghodadra NS, Provencher MT, Lewis PB, Bach BR (2011) Biceps tenotomy versus tenodesis: a review of clinical outcomes and biomechanical results. J Shoulder Elbow Surg 20:326–332. doi:10.1016/j.jse.2010.08.019 PubMedCrossRef

19.

Lee HI, Shon MS, KohKH Lim TK, Heo J, Yoo JC (2014) Clinical and radiologic results of arthroscopic biceps tenodesis with suture anchor in the setting of rotator cuff tear. J Shoulder Elbow Surg 23:e53–e60. doi:10.1016/j.jse.2013.06.004 PubMedCrossRef

20.

Gregory JM, Harwood DP, Gochanour E, Sherman SL, Romeo AA (2012) Clinical outcomes of revision biceps tenodesis. Int J Shoulder Surg 6:45–50. doi:10.4103/0973-6042.96993 PubMedPubMedCentralCrossRef

21.

Lafosse L, Van Raebroeckx A, Brzoska R (2006) A new technique to improve tissue grip: “The Lasso-Loop Stitch”. Arthroscopy 22:1246.e1–1246.e3. doi:10.1016/j.arthro.2006.05.021

22.

Mazzocca AD, Cote MP, Arciero CL, Romeo AA, Arciero RA (2008) Clinical outcomes after subpectoral biceps tenodesis with an interference screw. Am J Sports Med 36:1922–1929. doi:10.1177/0363546508318192 PubMedCrossRef

23.

Sears BW, Spencer EE, Getz CL (2011) Humeral fracture following subpectoral biceps tenodesis in 2 active, healthy patients. J Shoulder Elbow Surg 20:e7–e11. doi:10.1016/j.jse.2011.02.020 PubMedCrossRef

24.

Koch BS, Burks RT (2012) Failure of biceps tenodesis with interference screw fixation. Arthroscopy 28:735–740. doi:10.1016/j.arthro.2012.02.019 PubMedCrossRef

25.

Bradbury T, Dunn WR, Kuhn JE (2008) Preventing the Popeye deformity after release of the long head of the biceps tendon: an alternative technique and biomechanical evaluation. Arthroscopy 24:1099–1102. doi:10.1016/j.arthro.06.002 PubMedCrossRef

26.

Narvani AA, Atoun E, Van Tongel A, Sforza G, Levy O (2013) The “anchor shape” technique for long head of the biceps tenotomy to avoid the popeye deformity. Arthrosc Tech 2:e167–e170. doi:10.1016/j.eats.01.008 PubMedPubMedCentralCrossRef

27.

Sekiya JK, Elkousy HA, Rodosky MW (2003) Arthroscopic biceps tenodesis using the percutaneous intra-articular transtendon technique. Arthroscopy 19:1137–1141. doi:10.1016/j.arthro.2003.10.022 PubMedCrossRef

28.

Hedtmann A, Fett H, Heers G (2002) Läsionen im bereich des rotatore intervalls und der langen bizepssehne. In: Gohlke F, Hedtmann A (eds) Schulter: das Standardwerk für klinik und praxis. Georg thieme Verlag, Stuttgart, pp 310–316

Titel: Biceps tenodesis (long head): arthroscopic keyhole technique versus arthroscopic interference screw: a prospective comparative clinical and radiographic marker study
verfasst von: Jean Kany
Régis Guinand
Pierre Croutzet
Rajkumar Amaravathi
Padmanaban Sekaran
Publikationsdatum: 01.01.2016
Verlag: Springer Paris
Erschienen in: European Journal of Orthopaedic Surgery & Traumatology / Ausgabe 1/2016
Print ISSN: 1633-8065
Elektronische ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-015-1714-2

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Abstract

Purpose

Methods

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Conclusion

Level of evidence

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