Derek F P van Deurzen1, Navin Gurnani2, Tjarco D W Alta2, Jore H Willems2, Ron Onstenk3, Michel P J van den Bekerom4. 1. Department of Orthopedic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, P.O.Box 95500, 1090HM, Amsterdam. The Netherlands. Electronic address: d.vandeurzen@olvg.nl. 2. Department of Orthopedic Surgery, Spaarne Gasthuis, Hoofddorp, Spaarnepoort 1, 2134 TM Hoofddorp, The Netherlands. 3. Department of Orthopedic Surgery, Groene Hart Ziekenhuis, Gouda, Bleulandweg 10, 2803 HH Gouda, The Netherlands. 4. Department of Orthopedic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, P.O.Box 95500, 1090HM, Amsterdam. The Netherlands.
Abstract
BACKGROUND: Suprapectoral long head biceps (LHB) tenodesis and subpectoral LHB tenodesis are both commonly performed surgical procedures. Due to the more proximal position of the suprapectoral tenodesis site this technique may be accompanied with more postoperative pain in the bicipital groove and cramping pain in the biceps muscle. We hypothesized that subpectoral tenodesis is associated with a better clinical outcome than suprapectoral tenodesis. METHODS: A literature search was conducted in PubMed and Embase from January 2000 to July 2019 with the terms "biceps" and "tenodesis". Only comparing studies reporting on American Shoulder Elbow Score (ASES), VAS for anterior shoulder pain, Constant Murley Score (CMS), pain in the bicipital groove and Popeye deformity following suprapectoral and subpectoral tenodesis were included. Quality assessment of included articles was performed using the Coleman score. RESULTS: Seven comparative studies with 409 patients reporting the results of LHB suprapectoral and subpectoral tenodesis were included. A significant, but clinically irrelevant difference in ASES (mean difference 2.15) p=0.01 was observed. No significant difference in CMS (mean difference 0.09), VAS for anterior shoulder pain (mean difference 0.01), Popeye deformity (odds ratio 3.19) and persistent bicipital pain (odds ratio 2.66). The Coleman score ranged between 53 and 87. CONCLUSION: Based on this meta-analysis we found a significantly, though not clinically relevant difference in ASES in favour of subpectoral LHB tenodesis when compared with suprapectoral LHB tenodesis. Comparable results were found with regard to outcome scores, pain in the bicipital groove and avoiding a Popeye deformity.
BACKGROUND: Suprapectoral long head biceps (LHB) tenodesis and subpectoral LHB tenodesis are both commonly performed surgical procedures. Due to the more proximal position of the suprapectoral tenodesis site this technique may be accompanied with more postoperative pain in the bicipital groove and cramping pain in the biceps muscle. We hypothesized that subpectoral tenodesis is associated with a better clinical outcome than suprapectoral tenodesis. METHODS: A literature search was conducted in PubMed and Embase from January 2000 to July 2019 with the terms "biceps" and "tenodesis". Only comparing studies reporting on American Shoulder Elbow Score (ASES), VAS for anterior shoulder pain, Constant Murley Score (CMS), pain in the bicipital groove and Popeye deformity following suprapectoral and subpectoral tenodesis were included. Quality assessment of included articles was performed using the Coleman score. RESULTS: Seven comparative studies with 409 patients reporting the results of LHB suprapectoral and subpectoral tenodesis were included. A significant, but clinically irrelevant difference in ASES (mean difference 2.15) p=0.01 was observed. No significant difference in CMS (mean difference 0.09), VAS for anterior shoulder pain (mean difference 0.01), Popeye deformity (odds ratio 3.19) and persistent bicipital pain (odds ratio 2.66). The Coleman score ranged between 53 and 87. CONCLUSION: Based on this meta-analysis we found a significantly, though not clinically relevant difference in ASES in favour of subpectoral LHB tenodesis when compared with suprapectoral LHB tenodesis. Comparable results were found with regard to outcome scores, pain in the bicipital groove and avoiding a Popeye deformity.
Authors: Bauke Kooistra; Navin Gurnani; Alexander Weening; Derek van Deurzen; Michel van den Bekerom Journal: Arthrosc Sports Med Rehabil Date: 2021-07-03
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