Skip to main content
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 12/2016

15.05.2015 | Shoulder

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

verfasst von: Navin Gurnani, Derek F. P. van Deurzen, Vincent T. Janmaat, Michel P. J. van den Bekerom

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 12/2016

Einloggen, um Zugang zu erhalten

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.
Literatur
1.
Zurück zum Zitat 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):747–757PubMed 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):747–757PubMed
2.
Zurück zum Zitat 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):2553–2558CrossRefPubMed 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):2553–2558CrossRefPubMed
3.
Zurück zum Zitat 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):801–807PubMed 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):801–807PubMed
4.
Zurück zum Zitat 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):2–11CrossRefPubMed 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):2–11CrossRefPubMed
5.
Zurück zum Zitat 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):1161–1168CrossRefPubMed 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):1161–1168CrossRefPubMed
6.
Zurück zum Zitat 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 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
7.
Zurück zum Zitat 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–S52CrossRefPubMed 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–S52CrossRefPubMed
8.
Zurück zum Zitat 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):828–833CrossRefPubMed 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):828–833CrossRefPubMed
9.
Zurück zum Zitat 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):247–249CrossRefPubMed 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):247–249CrossRefPubMed
10.
Zurück zum Zitat 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):1584–1590CrossRefPubMed 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):1584–1590CrossRefPubMed
11.
Zurück zum Zitat 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 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
12.
Zurück zum Zitat 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–e88CrossRefPubMedPubMedCentral 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–e88CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat 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):250–255CrossRefPubMed 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):250–255CrossRefPubMed
14.
Zurück zum Zitat 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 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
15.
Zurück zum Zitat 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):121–130CrossRefPubMed 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):121–130CrossRefPubMed
16.
Zurück zum Zitat 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):1046–1052CrossRefPubMed 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):1046–1052CrossRefPubMed
17.
Zurück zum Zitat 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):41–46CrossRefPubMed 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):41–46CrossRefPubMed
18.
Zurück zum Zitat 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):9–16CrossRefPubMed 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):9–16CrossRefPubMed
19.
Zurück zum Zitat Yamaguchi K, Riew KD, Galatz LM, Syme JA, Neviaser RJ (1997) Biceps activity during shoulder motion: an electromyographic analysis. Clin Orthop Relat Res 336:122–129CrossRef Yamaguchi K, Riew KD, Galatz LM, Syme JA, Neviaser RJ (1997) Biceps activity during shoulder motion: an electromyographic analysis. Clin Orthop Relat Res 336:122–129CrossRef
20.
Zurück zum Zitat 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):238–246CrossRefPubMed 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):238–246CrossRefPubMed
21.
Zurück zum Zitat 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):849–852CrossRefPubMed 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):849–852CrossRefPubMed
22.
Zurück zum Zitat 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):366–372CrossRefPubMed 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):366–372CrossRefPubMed
23.
Zurück zum Zitat 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):857–865CrossRefPubMed 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):857–865CrossRefPubMed
24.
Zurück zum Zitat 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):464–469CrossRefPubMed 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):464–469CrossRefPubMed
Metadaten
Titel
Tenotomy or tenodesis for pathology of the long head of the biceps brachii: a systematic review and meta-analysis
verfasst von
Navin Gurnani
Derek F. P. van Deurzen
Vincent T. Janmaat
Michel P. J. van den Bekerom
Publikationsdatum
15.05.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 12/2016
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-015-3640-6

Weitere Artikel der Ausgabe 12/2016

Knee Surgery, Sports Traumatology, Arthroscopy 12/2016 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.