Document Detail


Treatment of biceps tendon lesions in the setting of rotator cuff tears: prospective cohort study of tenotomy versus tenodesis.
MedLine Citation:
PMID:  20551285     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: During rotator cuff repair, biceps tendon lesions are frequently encountered. However, there is still controversy about optimal treatment for these lesions.
PURPOSE: To compare the results of tenotomy and suture anchor tenodesis prospectively.
STUDY DESIGN: Cohort study; Level of evidence, 2.
METHODS: From January 2006 to June 2007, 90 patients (age, >55 years) with a rotator cuff tear and biceps tendon lesion (tear more than 30%, subluxation or dislocation, or degenerative superior labrum anterior to posterior lesion type II) were evaluated prospectively. The first 45 patients treated consecutively underwent biceps tenodesis, and the next 45 underwent biceps tenotomy. Postoperatively, patient evaluations were conducted with a focus on (1) "Popeye" deformity, (2) arm cramping pain, and (3) elbow flexion powers (measured with a hand dynamometer). Overall shoulder function was assessed with the American Shoulder and Elbow Surgeons (ASES) score and the Constant score.
RESULTS: At final follow-up, 43 in the tenodesis and 41 in the tenotomy groups were available for evaluation. There was no difference between groups in demographic data such as age, sex, dominant arm, and the time from symptom to surgery and in preoperative ASES score, Constant score, and rotator cuff tear size. A Popeye deformity occurred in 4 (9%) in the tenodesis group and in 11 (27%) in the tenotomy group (P = .0360). Mild cramping pain was observed in 2 in the tenodesis group and 4 in the tenotomy group (P = .4274). Mean elbow flexor power ratio (vs the contralateral side) showed no difference between the 2 groups, with mean values of 0.92 +/- 0.15 (tenodesis) and 0.94 +/- 0.19 (tenotomy) (P = .7475). The ASES and Constant scores were improved from 38.9 +/- 14.2 and 52.1 +/- 21.3 to 84.7 +/- 13.6 and 82.9 +/- 13.5 in the tenodesis group (P < .0001) and from 35.2 +/- 10.5 and 48.1 +/- 21.3 to 79.6 +/- 15.8 and 78.3 +/- 14.1 in the tenotomy group (P < .0001), respectively.
CONCLUSION: Suture anchor tenodesis of the long head of the biceps tendon appears to lead to less Popeye deformity than tenotomy. No other clinical variables showed a difference between the 2 modalities.
Authors:
Kyoung Hwan Koh; Jin Hwan Ahn; Sang Min Kim; Jae Chul Yoo
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-06-15
Journal Detail:
Title:  The American journal of sports medicine     Volume:  38     ISSN:  1552-3365     ISO Abbreviation:  Am J Sports Med     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-02     Completed Date:  2010-12-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7609541     Medline TA:  Am J Sports Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1584-90     Citation Subset:  IM    
Affiliation:
Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Gu, Seoul, Korea. osdoc.koh@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Arm*
Cohort Studies
Female
Humans
Humerus / surgery
Male
Middle Aged
Muscle, Skeletal / surgery*
Outcome Assessment (Health Care)
Prospective Studies
Rotator Cuff / injuries*,  surgery
Shoulder Joint / surgery
Tendon Injuries / surgery*
Tenodesis*
Comments/Corrections
Comment In:
Z Orthop Unfall. 2010 Sep;148(5):508   [PMID:  20931697 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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