2021 ISAKOS Biennial Congress Paper
Open Subpectoral Biceps Tenodesis Versus Arthroscopic Repair For Slap Tears In Patients Under 30
Eoghan T. Hurley, MB, BCh, MCh, Dubline, Dublin IRELAND
Christopher Angelo Colasanti, MD, New York, New York UNITED STATES
Nathan A Lorentz, BS , New York, NY UNITED STATES
Kirk Anthony Campbell, MD, New York, NY UNITED STATES
Laith M. Jazrawi, MD, New York, NY UNITED STATES
Eric Jason Strauss, MD
Bogdan Matache, MD, Ottowa, Ontario CANADA
Michael J Alaia, MD, New York, New York UNITED STATES
NYU Langone, New York, New York, UNITED STATES
FDA Status Not Applicable
Summary
Biceps tenodesis is a reliable alternative to arthroscopic repair, with a lower rate of revision surgery, and excellent patient reported outcomes.
Abstract
Purpose
The purpose of the current study is to compare the outcomes of BT to AR for SLAP tears in patients under the age of 30. Our hypothesis was that there would be no statistically significant difference in outcomes between the two procedures.
STUDY DESIGN: Retrospective Comparative Study; Level of evidence III
Methods
A retrospective review of patients who underwent either isolated BT or AR for the diagnosis of a SLAP tear was performed. Patients with a follow-up duration of <24 months were excluded. The American Shoulder & Elbow Surgeons (ASES) score, Visual Analogue Scale (VAS), Subjective Shoulder Value (SSV), patient satisfaction, willingness to undergo surgery again, revisions, and return to play (RTP) were evaluated. A p value of <0.05 was considered to be statistically significant.
Results
Our study included 103 patients in total; 29 patients were treated with BT, and 74 were treated with AR. The mean age was 24.8 years, 79.4% were male, and the mean follow-up duration was 60 months. At final follow up, there was no difference between treatment groups in any of the functional outcome measures assessed (p > 0.05). Overall, there was no significant difference in the total rate of RTP (BT: 76.3%, AR: 85%; p = 0.53), timing of RTP (BT: 8.8 months, AR: 9.4 months; p = 0.61), and total rate of RTP among overhead athletes (BT: 84.2%, AR: 83.3%; p = 1). However, there was a significantly lower rate of revision surgery with BT (0%) as compared to AR (14.1%; p = 0.03).
Conclusion
The most important finding from this study was that in patients under the age of 30 with a symptomatic isolated SLAP tear, biceps tenodesis is a reliable alternative to arthroscopic repair, with a lower rate of revision surgery, and excellent patient reported outcomes. Furthermore, there was a high rate of RTP among athletes, with no difference in RTP metrics between the two groups, and no difference among overhead athletes.