Arnaud Godenèche1, Jean-François Kempf2, Laurent Nové-Josserand1, Aude Michelet3, Mo Saffarini4, Gerjon Hannink5, Philippe Collin6. 1. Ramsay Générale de Santé, Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, Lyon, France. 2. Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France. 3. ReSurg SA, Nyon, Switzerland. 4. ReSurg SA, Nyon, Switzerland. Electronic address: journals@resurg.eu. 5. Orthopaedic Research Laboratory, Radboud University Medical Center, Nijmegen, The Netherlands. 6. Saint-Grégoire Private Hospital Center, Saint-Grégoire, France.
Abstract
BACKGROUND: Many authors recommend systematic biceps tenotomy or tenodesis when repairing rotator cuff tears, regardless of whether the biceps is normal or pathologic. The purpose of this study was to determine whether 10-year outcomes of repairs of isolated supraspinatus tears are influenced by adjuvant biceps tenodesis or tenotomy. METHODS: Patients who underwent repair of isolated supraspinatus tears were recalled for evaluation at a minimum follow-up of 10 years. A total of 249 patients (51% men) aged 56.7 ± 6.3 years were evaluated clinically (Constant score), of whom 182 were also evaluated using magnetic resonance imaging (Sugaya classification). The biceps was intraoperatively found to be pathologic in 52% of shoulders, of which 39% had a tenotomy and 54% had a tenodesis; it was found to be normal in 48% of shoulders, of which 88% were left intact. RESULTS: There were no significant differences in Constant scores for patients who had normal biceps without adjuvant procedures (77.1 ± 11.7) compared with patients who had pathologic biceps with either tenodesis (79.8 ± 11.5, P = .104) or tenotomy (75.3 ± 10.7, P = .420). However, for patients who had pathologic biceps, Constant scores were significantly better for those with tenodesis compared with those with tenotomy (P = .025). Multivariable regression revealed Constant scores to be significantly lower for women, as well as patients with fatty infiltration of stages 1 and 2, but significantly higher for patients who underwent tenodesis. CONCLUSION: Adjuvant biceps procedures are not required when repairing isolated supraspinatus tears, unless biceps pathology is observed intraoperatively, for which tenodesis grants better function and strength than tenotomy.
BACKGROUND: Many authors recommend systematic biceps tenotomy or tenodesis when repairing rotator cuff tears, regardless of whether the biceps is normal or pathologic. The purpose of this study was to determine whether 10-year outcomes of repairs of isolated supraspinatus tears are influenced by adjuvant biceps tenodesis or tenotomy. METHODS:Patients who underwent repair of isolated supraspinatus tears were recalled for evaluation at a minimum follow-up of 10 years. A total of 249 patients (51% men) aged 56.7 ± 6.3 years were evaluated clinically (Constant score), of whom 182 were also evaluated using magnetic resonance imaging (Sugaya classification). The biceps was intraoperatively found to be pathologic in 52% of shoulders, of which 39% had a tenotomy and 54% had a tenodesis; it was found to be normal in 48% of shoulders, of which 88% were left intact. RESULTS: There were no significant differences in Constant scores for patients who had normal biceps without adjuvant procedures (77.1 ± 11.7) compared with patients who had pathologic biceps with either tenodesis (79.8 ± 11.5, P = .104) or tenotomy (75.3 ± 10.7, P = .420). However, for patients who had pathologic biceps, Constant scores were significantly better for those with tenodesis compared with those with tenotomy (P = .025). Multivariable regression revealed Constant scores to be significantly lower for women, as well as patients with fatty infiltration of stages 1 and 2, but significantly higher for patients who underwent tenodesis. CONCLUSION: Adjuvant biceps procedures are not required when repairing isolated supraspinatus tears, unless biceps pathology is observed intraoperatively, for which tenodesis grants better function and strength than tenotomy.
Authors: László Bucsi; Károly Schandl; Mátyás Vajda; Lajos Szakó; Péter Hegyi; Bálint Erőss; Anikó Görbe; Zsolt Molnár; Kincső Kozma; Gergő Józsa Journal: Int Orthop Date: 2022-03-07 Impact factor: 3.479
Authors: Dragomir Mijic; Jennifer Kurowicki; Derek Berglund; Samuel Rosas; Emmanuel McNeely; Matthew Motisi; Teja Polisetty; Jonathan C Levy Journal: JSES Int Date: 2020-02-24