Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 2/2015

01-02-2015 | Shoulder

Tenotomy or tenodesis for long head biceps lesions in shoulders with reparable rotator cuff tears: a prospective randomised trial

Authors: Qiang Zhang, Jiaojiao Zhou, Heng’an Ge, Biao Cheng

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 2/2015

Login to get access

Abstract

Purpose

Tenotomy and tenodesis are both effective for the treatment of long head biceps lesions. The aim of this study was to compare the clinical outcomes of the two procedures in patients older than 55 years of age affected by reparable rotator cuff tears with concomitant long head biceps pathologies.

Methods

Patients older than 55 years of age with long head biceps lesions and reparable rotator cuff tears were selected for this study. A total of 151 patients were randomly assigned to the tenotomy group (77 patients) or the tenodesis group (74 patients). Arthroscopic rotator cuff repair was performed in all the patients. Before surgery, physical and radiological examinations were performed; the constant score was measured as well. After the operation, the surgical time, cost, pain (VAS scores), Popeye sign, cramping pain, constant scores, satisfaction level and the elbow flexion and forearm supination strength indices were recorded.

Results

Patients were followed for an average of 24 months. No significant differences in the clinical results for the constant scores, the forearm supination and elbow flexion strength indices, Popeye sign, cramping pain and satisfaction level were found between the groups. However, tenotomy required a shorter surgical time (40.4 ± 4.0 vs. 50.4 ± 5.9 min, P < 0.001) and resulted in faster pain relief (3.1 ± 1.8 vs. 4.8 ± 1.9, P < 0.001).

Conclusion

Both tenotomy and tenodesis are effective and equal for the treatment of long head biceps lesions. However, because tenotomy requires a shorter surgical time and results in faster pain relief, tenotomy may be more suitable for the treatment of long head biceps lesions in patients older than 55 years of age with reparable rotator cuff tears.

Level of evidence

Therapeutic studies, Level I.
Literature
1.
Ahmad CS, DiSipio C, Lester J, Gardner TR, Levine WN, Bigliani LU (2007) Factors affecting dropped biceps deformity after tenotomy of the long head of the biceps tendon. Arthroscopy 23(5):537–541PubMedCrossRef
2.
Ahmad CS, ElAttrache NS (2003) Arthroscopic biceps tenodesis. Orthop Clin N Am 34(4):499–506CrossRef
3.
Ahrens PM, Boileau P (2007) The long head of biceps and associated tendinopathy. J Bone Joint Surg Br 89(8):1001–1009PubMedCrossRef
4.
Barber FA, Field LD, Ryu RK (2008) Biceps tendon and superior labrum injuries: decision making. Instr Course Lect 57:527–538PubMed
5.
Boileau P, Ahrens PM, Hatzidakis AM (2004) Entrapment of the long head of the biceps tendon: the hourglass biceps—a cause of pain and locking of the shoulder. J Shoulder Elbow Surg 13(3):249–257PubMedCrossRef
6.
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 rotator cuff tears. J Bone Joint Surg Am 89(4):747–757PubMedCrossRef
7.
Checchia SL, Doneux PS, Miyazaki AN, Silva LA, Fregoneze M, Ossada A, Tsutida CY, Masiole C (2005) Biceps tenodesis associated with arthroscopic repair of rotator cuff tears. J Shoulder Elbow Surg 14(2):138–144PubMedCrossRef
8.
De Carli A, Vadala 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):2553–2558PubMedCrossRef
9.
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–S52PubMedCrossRef
10.
Duff SJ, Campbell PT (2012) Patient acceptance of long head of biceps brachii tenotomy. J Shoulder Elbow Surg 21(1):61–65PubMedCrossRef
11.
Franceschi F, Longo UG, Ruzzini L, Papalia R, Rizzello G, Denaro V (2007) To detach the long head of the biceps tendon after tenodesis or not: outcome analysis at the 4-year follow-up of two different techniques. Int Orthop 31(4):537–545PubMedCentralPubMedCrossRef
12.
Franceschi F, Longo UG, Ruzzini L, Rizzello G, Maffulli N, Denaro V (2008) No advantages in repairing a type II superior labrum anterior and posterior (SLAP) lesion when associated with rotator cuff repair in patients over age 50: a randomized controlled trial. Am J Sports Med 36(2):247–253PubMedCrossRef
13.
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):828–833PubMedCrossRef
14.
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):247–249PubMedCrossRef
15.
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(2):326–332PubMedCrossRef
16.
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(2):208–213PubMedCrossRef
17.
18.
Klinger HM, Spahn G, Baums MH, Steckel H (2005) Arthroscopic debridement of irreparable massive rotator cuff tears—a comparison of debridement alone and combined procedure with biceps tenotomy. Acta Chir Belg 105(3):297–301PubMed
19.
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):1584–1590PubMedCrossRef
20.
Lo IK, Burkhart SS (2004) Arthroscopic biceps tenodesis using a bioabsorbable interference screw. Arthroscopy 20(1):85–95PubMedCrossRef
21.
Mazzocca AD, Rios CG, Romeo AA, Arciero RA (2005) Subpectoral biceps tenodesis with interference screw fixation. Arthroscopy 21(7):896.e1–896.e7CrossRef
22.
Miller T, Jones G (2011) Arthroscopic evaluation and treatment of biceps brachii long head tendon injuries: a survey of the MOON shoulder group. Int J Shoulder Surg 5(3):68–71PubMedCentralPubMedCrossRef
23.
Nassos JT, Chudik SC (2009) Arthroscopic rotator cuff repair with biceps tendon augmentation. Am J Orthop (Belle Mead NJ) 38(6):279–281
24.
Nho SJ, Shindle MK, Sherman SL, Freedman KB, Lyman S, MacGillivray JD (2007) Systematic review of arthroscopic rotator cuff repair and mini-open rotator cuff repair. J Bone Joint Surg Am 89(Suppl 3):127–136PubMedCrossRef
25.
Osbahr DC, Diamond AB, Speer KP (2002) The cosmetic appearance of the biceps muscle after long-head tenotomy versus tenodesis. Arthroscopy 18(5):483–487PubMedCrossRef
26.
Park JY, Lhee SH, Choi JH, Park HK, Yu JW, Seo JB (2008) Comparison of the clinical outcomes of single- and double-row repairs in rotator cuff tears. Am J Sports Med 36(7):1310–1316PubMedCrossRef
27.
Patton WC, McCluskey GM 3rd (2001) Biceps tendinitis and subluxation. Clin Sports Med 20(3):505–529PubMedCrossRef
28.
RL (1944) Bicipital tenosynovitis. NY State J Med 44:2235–2240
29.
Randelli P, Arrigoni P, Cabitza F, Ragone V, Cabitza P (2012) Current practice in shoulder pathology: results of a web-based survey among a community of 1,084 orthopedic surgeons. Knee Surg Sports Traumatol Arthrosc 20(5):803–815PubMedCrossRef
30.
Sethi N, Wright R, Yamaguchi K (1999) Disorders of the long head of the biceps tendon. J Shoulder Elbow Surg 8(6):644–654PubMedCrossRef
31.
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):9–16PubMedCrossRef
32.
Slenker NR, Lawson K, Ciccotti MG, Dodson CC, Cohen SB (2012) Biceps tenotomy versus tenodesis: clinical outcomes. Arthroscopy 28(4):576–582PubMedCrossRef
33.
Walch G, Edwards TB, Boulahia A, Nove-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):238–246PubMedCrossRef
34.
Wolf RS, Zheng N, Weichel D (2005) Long head biceps tenotomy versus tenodesis: a cadaveric biomechanical analysis. Arthroscopy 21(2):182–185PubMedCrossRef
Metadata
Title
Tenotomy or tenodesis for long head biceps lesions in shoulders with reparable rotator cuff tears: a prospective randomised trial
Authors
Qiang Zhang
Jiaojiao Zhou
Heng’an Ge
Biao Cheng
Publication date
01-02-2015
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 2/2015
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-013-2587-8

Other articles of this Issue 2/2015

Knee Surgery, Sports Traumatology, Arthroscopy 2/2015 Go to the issue

Shoulder

Predictive value of preoperative clinical examination for subacromial decompression in impingement syndrome

Shoulder

Subpectoral biceps tenodesis: a new technique using an all-suture anchor fixation

Shoulder

A cruciate suture technique for rotator cuff repair

Shoulder

Association between pre-operative magnetic resonance imaging and reparability of large and massive rotator cuff tears

Shoulder

Pit above the lesser tuberosity in axial view radiography

Shoulder

Rapid collapse of the humeral head after arthroscopic rotator cuff repair