Original Articles
The cosmetic appearance of the biceps muscle after long-head tenotomy versus tenodesis*

https://doi.org/10.1053/jars.2002.32233Get rights and content

Abstract

Purpose: This study evaluates the cosmetic appearance of the biceps muscle after arthroscopic, intra-articular biceps tenotomy versus tenodesis by presenting subjective outcome results in patients with refractive bicipital pain. Type of Study: Retrospective study evaluating clinical follow-up of patients with refractive and chronic bicipital pain. Methods: Five consecutive years of patients receiving biceps tenotomy (80 patients; 40 males, 40 females; average age, 58 years) or tenodesis (80 patients; 51 males, 29 females; average age, 54 years) procedures were retrospectively followed-up by grading anterior shoulder pain, muscle spasms in the biceps, and cosmetic deformity of the biceps muscle. Statistics were done by χ2 analysis. Results: When assessing the follow-up questions, no statistical significance was found between the biceps tenotomy and biceps tenodesis groups. There was also no statistical significance when comparing the biceps tenotomy and biceps tenodesis groups when evaluating only the men, women, and men versus women with respect to the questions assessed. Conclusions: In the majority of patients in which a biceps tenotomy is performed, we note that the cosmetic appearance of the biceps muscle, the grade of muscle spasms of the biceps, and the level of anterior shoulder pain would present with little difference than if a tenodesis had been performed. Therefore, a biceps tenotomy may be a reasonable alternative to a biceps tenodesis in patients with refractive and chronic bicipital pain.

Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 18, No 5 (May-June), 2002: pp 483–487

Section snippets

Methods

We retrospectively reviewed 279 patients who had undergone either a biceps tenotomy or biceps tenodesis by the senior author (D.C.O) during 5 consecutive years. These procedures were performed as a component of a spectrum of procedures to include subacromial decompression, rotator cuff repair, distal clavicle excision, and debridement of chronic rotator cuff tear. The indications to perform a biceps tenodesis or tenotomy was based on a clinical examination in which the patient reported point

Results

Demographic information obtained from the 160 patients who returned their follow-up questionnaires showed that the biceps tenodesis patients were an average age of 54 years with an age range from 23 and 76 years. There were 51 men and 29 women. Of the biceps tenotomy patients, the average age was 58 years with an age range from 31 to 83 years. There were 40 men and 40 women. The average time interval from surgery to follow-up in the biceps tenodesis group was 20 months with a range from 3 to 50

Discussion

In addition to the controversies surrounding biceps function and the etiology of bicipital pain, treatment options for the painful biceps tendon are similarly contentious. Biceps tenodesis to the proximal humerus is widely described but has obvious shortcomings, including open surgical exploration.13, 14, 20, 21, 22, 23, 24 An alternative to tenodesis is simple surgical release or tenotomy.19, 25

According to our results, patients who receive an arthroscopic biceps tenotomy experience a similar

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    *

    Address correspondence and reprint requests to Kevin P. Speer, M.D., Southeastern Orthopedics Sports Medicine and Shoulder Center, 3404 Wake Forest Rd, Suite 101, Raleigh, NC 27609, U.S.A. E-mail: [email protected]

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