PROXIMAL BICEPS TENODESIS INCORPORATED INTO ROTATOR CUFF REPAIR
PURPOSE: Multiple different techniques have been described for performing long head of the biceps tenodesis but most of these studies are biomechanical with few clinical studies. Presented here is a study evaluating the outcomes of an all-arthroscopic intra-cuff tenodesis technique.
METHODS: 19 patients were followed for an average of 2.0 years after biceps tenodesis and concomitant rotator cuff repair. A suture anchor was placed for the rotator cuff repair. The biceps was tenotomized arthroscopically. Suture from the most medial and anterior rotator cuff repair anchor was shuttled through the biceps tendon followed by the rotator cuff. This suture was then tied incorporating the biceps tenodesis into the cuff repair.
RESULTS: ASES scores improved from 45.9 pre-operatively to 91.6 at 2 years (p<0.001). VAS scores improved from 5.2 pre-op to 0.7 at 2 year follow up (p<0.001). 18 patients had a positive Speed’s test pre-operatively and all 18 had a negative test at 5 months post-operatively. 21 patients had bicipital groove tenderness pre-operatively which resolved in all 21 patients at 5 months post-op. Two patients had cramping pain at 2 years. There were no reoperations. No complications occurred in the study group.
CONCLUSION: All-arthroscopic intracuff biceps tenodesis appears to be a safe and reliable option for biceps pathology with a concomitant rotator cuff tear. Advantages of this technique include the all-arthroscopic technique and the decreased cost of avoiding an extra anchor or hardware.