Dataset Information

All-Arthroscopic Biceps Tenodesis Using the Anterolateral Anchor During Concomitant Double-Row Rotator Cuff Repair.

ABSTRACT: Arthroscopic biceps tenodesis is a commonly performed procedure; however, there is a paucity of literature regarding concomitant biceps tenodesis and double-row rotator cuff repair. In this Technical Note, we describe an all-arthroscopic biceps tenodesis using the stay sutures from the anterolateral anchor in the setting of a double-row rotator cuff repair. The anterolateral anchor is placed adjacent to the bicipital groove to accommodate the tenodesis. Two sutures loaded into the anterolateral anchor are passed through the long head of the biceps tendon in a cinch configuration without the need to externalize the tendon. The sutures are tied arthroscopically, thereby securing the tendon to the anterolateral row anchor and completing the tenodesis.

SUBMITTER: Meghpara M

PROVIDER: S-EPMC6993188 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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All-Arthroscopic Biceps Tenodesis Using the Anterolateral Anchor During Concomitant Double-Row Rotator Cuff Repair.

Meghpara Mitchell M Schulz William W Golan Elan E Vyas Dharmesh D

Arthroscopy techniques 20191218 1

Arthroscopic biceps tenodesis is a commonly performed procedure; however, there is a paucity of literature regarding concomitant biceps tenodesis and double-row rotator cuff repair. In this Technical Note, we describe an all-arthroscopic biceps tenodesis using the stay sutures from the anterolateral anchor in the setting of a double-row rotator cuff repair. The anterolateral anchor is placed adjacent to the bicipital groove to accommodate the tenodesis. Two sutures loaded into the anterolateral ...[more]

PMID: 32021779

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Project description:BackgroundStudies to date comparing biceps tenodesis methods in the setting of concomitant rotator cuff repair (RCR) have demonstrated relatively equivalent pain and functional outcomes.PurposeTo compare biceps tenodesis constructs, locations, and techniques in patients who underwent RCR using a large multicenter database.Study designCohort study; Level of evidence, 3.MethodsA global outcome database was queried for patients with medium- and large-sized tears who underwent biceps tenodesis with RCR between 2015 and 2021. Patients ≥18 years of age with a minimum follow-up of 1 year were included. The American Shoulder and Elbow Surgeons, Single Assessment Numeric Evaluation, visual analog scale for pain, and Veterans RAND 12-Item Health Survey (VR-12) scores were compared at 1 and 2 years of follow-up based on construct (anchor, screw, or suture), location (subpectoral, suprapectoral, or top of groove), and technique (inlay or onlay). Nonparametric hypothesis testing was used to compare continuous outcomes at each time point. The proportion of patients achieving the minimal clinically important difference (MCID) at the 1- and 2-year follow-ups were compared between groups using chi-square tests.ResultsA total of 1903 unique shoulder entries were analyzed. Improvement in VR-12 Mental score favored anchor and suture fixations at 1 year of follow-up (P = .042) and the onlay tenodesis technique at 2 years of follow-up (P = .029). No additional tenodesis comparisons demonstrated statistical significance. The proportion of patients with improvement exceeding the MCID did not differ based on tenodesis methods for any outcome score assessed at the 1- or 2-year follow-up.ConclusionBiceps tenodesis with concomitant RCR led to improved outcomes regardless of tenodesis fixation construct, location, or technique. A clear optimal tenodesis method with RCR remains to be determined. Surgeon preference and experience with various tenodesis methods as well as patient clinical presentation should continue to guide surgical decision-making.

Project description:Optimal treatment of the diseased long head of the biceps (LHB) tendon during rotator cuff repair remains a topic of debate: tenotomy or tenodesis. A recent meta analysis revealed no difference in strength or functional outcome between treatments. The included studies varied in methodological quality, and only two were randomized controlled trials (RCTs). As strong evidence in favor of either tenotomy or tenodesis is still lacking, we designed this randomized controlled trial to compare functional outcomes after tenotomy and tenodesis when performed in adjunct to arthroscopic rotator cuff repair.Patients older than 50 years with a supraspinatus and/or infraspinatus tendon rupture sized smaller than 3 cm, who are encountered with LHB pathology, will be randomized to either LHB tenotomy or LHB tenodesis. Clinical and patient-reported data will be collected pre-operatively, 6 weeks, 3 months and 1 year after surgery. Primary outcome is overall shoulder function evaluated with the Constant score at 1 year after surgery. As additional measures of shoulder function, two patient reported outcomes (the Dutch Oxford Shoulder Test and the Disabilities of the Arm Shoulder and Hand questionnaire) will be assessed. Other evaluations include cosmetic appearance evaluated by the "Popeye" deformity, elbow flexion strength, arm cramping pain, MRI-based location of the biceps tendon, quality of life, and duration of surgery. To detect non-inferiority with a one-sided, two-sample t-test with 80 % power and a significance level (alpha) of 0.025, the required sample size is 98 patients.Treatment of LHB tendon lesions is performed differently around the world and meta analyses do not provide conclusive evidence in favor of one of these treatments. This study will strengthen evidence on the risks and benefits of LHB tenotomy and tenodesis in adjunct to a rotator cuff repair, which is important for managing patient expectations.Dutch Trial Register ( NTR3255 ) January 12, 2012, ClinicalTrials.gov (ID NCT02655848 ) January 14, 2016, retrospectively registered.

Dataset Information

All-Arthroscopic Biceps Tenodesis Using the Anterolateral Anchor During Concomitant Double-Row Rotator Cuff Repair.

Publications

All-Arthroscopic Biceps Tenodesis Using the Anterolateral Anchor During Concomitant Double-Row Rotator Cuff Repair.

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