Summary
Biceps tenodesis with the use of a free needle to pass suture results in a significantly lower clinical failure rate compared with the use of a BirdBeak suture passer.
Abstract
Introduction
The purpose of this study was to compare the clinical failure rates of two methods of suture passage in biceps tenodesis performed by the senior surgeon. The authors hypothesized that biceps tenodesis using a free needle to pass suture through the long head of the biceps (LHB) tendon would result in a significantly lower clinical failure rate compared with tenodesis using a BirdBeak (Arthrex Inc., Naples, FL) suture passer.
Materials And Methods
A retrospective chart review was conducted of patients undergoing biceps tenodesis under the care of the senior author from January 2010 to May 2016. Operative notes were used to determine whether the procedure was performed with a BirdBeak suture passer (BB) or a free needle (FN). Clinical follow-up notes were used to determine participation in physical therapy and duration, follow-up duration, and if clinical tenodesis failure had occurred. Biceps tenodesis failure was defined as either cosmetic deformity (“Popeye” sign), pain at the tenodesis site, or need for revision.
Results
One hundred and sixty-three patients met inclusion and exclusion criteria (BB: 112, FN: 51). Average follow-up among all patients was 4.9 months. All patients underwent either formal or at home physical therapy and the average duration of physical therapy was not statistically different between groups (BB: 3.7 months, FN: 4.2 months, p = 0.27). There were significantly more tenodesis failures in the BB group (BB: 12%, FN: 2%, p = 0.042). Among all BB patients, 10% failed due to cosmetic deformity, 2% required revision, and 4% had postoperative pain at the tenodesis site by latest follow-up. The one FN patient who failed presented with cosmetic deformity postoperatively.
Conclusion
Biceps tenodesis with the use of a free needle to pass suture results in a significantly lower clinical failure rate compared with the use of a BirdBeak suture passer.