To evaluate the functional outcomes and structural integrity of primary subpectoral biceps tenodesis using an all-suture anchor onlay technique for long head of the biceps tendon (LHBT) pathology.
A retrospective case series with prospectively collected data of patients who underwent primary, isolated subpectoral biceps tenodesis with a single all-suture anchor onlay fixation between March 2017 and March 2019 was conducted. Outcomes were recorded at a minimum follow-up of 12 months based on assessments of the American Shoulder and Elbow Surgeons (ASES) score, long head of the biceps (LHB) score, and elbow flexion and supination strength measurements. Integrity of the tenodesis construct was evaluated using ultrasound.
Thirty-four patients were available for clinical and ultrasound examination at a mean follow-up of 18 ± 5 months. Mean ASES score significantly improved from 51.0 ± 14.2 points preoperatively to 89.8 ± 10.5 points postoperatively (P < .001). The MCID was 8.7 for ASES, which was exceeded by 31 patients (91.2%). Mean postoperative LHB score was 92.2 ± 8.3 points. Regarding subcategories, an average of 47.2 ± 6.3 points was reached for “pain/cramps”, 26.4 ± 6.1 points for “cosmesis”, and 18.6 ± 2.6 points for “elbow flexion strength”. Both, elbow flexion and supination strength were similar compared to the non-operated side (PFlex = .169; PSup = .210). In 32 patients ultrasound examination showed an intact tenodesis construct, while two patients (5.9 %) sustained failure of the all-suture anchor fixation requiring revision.
Primary subpectoral biceps tenodesis using an all-suture anchor onlay technique for pathology of the LHBT provides reliable clinical results and a relatively low failure rate (5.9 %).