2015 ISAKOS Biennial Congress ePoster #2203

Clinical and Biomechanical Evaluation of an All-Arthroscopic Suprapectoral Biceps Tenodesis

Cynthia A Kahlenberg, MD, New York, New York UNITED STATES
Ronak M. Patel, MD, Westmont, IL UNITED STATES
Rueben Nair, MD, Reno, NV UNITED STATES
Prashant Deshmane, MD, Hartsville, SC UNITED STATES
Michael Terry, MD, Chicago, IL UNITED STATES
Northwestern University Feinberg School of Medicine, Chicago, IL, USA

FDA Status Cleared

Summary: This study demonstrates the excellent clinical and biomechanical outcomes of an all-arthroscopic biceps tenodesis technique.

Abstract:

Purpose

This study compares the biomechanical strength of an all-arthroscopic biceps tenodesis technique that places the LHB distal to the bicipital groove in the suprapectoral region, with a more traditional mini-open subpectoral tenodesis. This study also evaluates the clinical outcomes of patients who underwent biceps tenodesis using the all-arthroscopic technique.

Methods

For the biomechanical evaluation of the all-arthroscopic biceps tenodesis technique, in which the biceps tendon is secured to the suprapectoral region distal to the bicipital groove with an interference screw, 14 (7 matched pairs) fresh-frozen human cadaveric shoulders were used to compare load-to-failure and displacement at peak load to a traditional open subpectoral location. For the clinical evaluation, 49 consecutive patients (51 shoulders) with a mean follow-up of 2.4 years who underwent an all-arthroscopic biceps tenodesis were evaluated using the ASES score pre-operatively and at last follow-up, as well as the UCLA Shoulder Score at last follow-up.

Results

On biomechanical evaluation, there was no significant difference in peak failure load, displacement at peak load, or displacement after cyclic testing between the arthroscopic suprapectoral and mini-open subpectoral groups. In the clinical evaluation, the mean pre-operative ASES score was 65.4, compared to 87.1 at last follow-up. The mean UCLA score at last follow-up was 30.2. Forty-eight (94.1%) patients reported satisfaction with the surgery. In subgroup analysis comparing patients who had a rotator cuff repair or labral repair at time of tenodesis with patients who did not have either of these procedures, there were no significant differences in UCLA or ASES scores.

Conclusion

The excellent biomechanical strength as well as the high rate of satisfaction after surgery and high ASES and UCLA post-operative scores make this technique a novel option for treatment of biceps tendon pathology.