Saturday, September 14, 2013

Biceps tenodesis in the setting of rotator cuff repair - does it make a difference?

Clinical and radiologic results of arthroscopic biceps tenodesis with suture anchor in the setting of rotator cuff tear

These authors wanted to find the  clinical and radiologic results of arthroscopic biceps tenodesis in 84 patients having rotator cuff repair. The description of the management of the rotator cuff tear is sparse: "The residual biceps tendon was cut from a site just proximal to the sutures, and the remaining stump was excised at an attachment site to the superior labrum. Afterward, the rotator cuff and combined lesion were addressed." The anatomic outcome of the cuff surgery was not described even though 60 patients had post op MRI's.

Clinical measures were improved after surgery. Eleven patients had popeye deformity, indicating failure of the tenodesis, yet the presence of this deformity did not correlate with poorer clinical scores. postoperative magnetic resonance imagine analysis, 15 patients (25%) showed distal migration of tenodesed biceps tendon, although only 6 (7.1%) had clinical popeye. 

While the authors concluded that "arthroscopic biceps tenodesis with 1 suture anchor resulted in good clinical outcomes at 2 years postoperatively", the data presented do not show a relationship between the clinical outcome and the success of the tenodesis. The data presented do not suggest any advantage of tenodesis over tenotomy and do not distinguish the relative roles of the biceps surgery and the cuff surgery in determining the clinical result.

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