Proximal Biceps Tenodesis Incorporated into Supraspinatus Repair: A Case Series and Technical Description

Orthop J Sports Med. 2021 Jan 13;9(1):2325967120975354. doi: 10.1177/2325967120975354. eCollection 2021 Jan.

Abstract

Background: Biceps tendon pathology is commonly associated with rotator cuff tears. A multitude of different biceps tenodesis techniques have been studied, with limited clinical data on arthroscopic biceps tenodesis techniques incorporated into rotator cuff repairs.

Purpose: To evaluate the outcomes of an arthroscopic biceps tenodesis incorporated into a supraspinatus tendon repair.

Study design: Case series; Level of evidence, 4.

Methods: Patients undergoing surgical treatment of supraspinatus tendon tears with concomitant biceps tendon pathology were prospectively enrolled from 2014 to 2015. A total of 32 patients underwent combined biceps tenodesis and rotator cuff repair; of these, 19 patients were evaluated for a mean of 2.0 years. The primary outcome measures were the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES; patient self-report and physician assessment sections), visual analog scale (VAS) pain score, responses to specific biceps-related assessments, and biceps specific physical exam findings.

Results: Patient-reported ASES scores improved from 45.9 preoperatively to 91.6 at the 2-year follow-up (P < .001). Pain VAS scores improved from 5.2 preoperatively to 0.7 at the 2-year follow-up (P < .001). Preoperatively, 18 patients had a positive Speed test; all were negative at 5 months postoperatively, and 21 patients had bicipital groove tenderness preoperatively, which resolved in all 21 patients at 5 months postoperatively. At the 2-year follow-up, 2 patients had cramping arm pain and 4 patients noticed a change in arm contour. There were no reoperations. No complications occurred in the study group.

Conclusion: Arthroscopic biceps tenodesis incorporated into a supraspinatus tendon repair was a safe and reliable option for biceps pathology with a concomitant rotator cuff tear.

Keywords: all-arthroscopic; anchor tenodesis; biceps tenodesis; rotator cuff repair.