Original Articles
Results of biceps tenotomy for treatment of pathology of the long head of the biceps brachii*,**,*

https://doi.org/10.1067/mse.2001.114259Get rights and content

Abstract

Historically, the surgical treatment of bicipital pathology has been a variety of tenodesis techniques. The purpose of this study is to report the results of simple biceps tenotomy for the treatment of bicipital pathology. Thirty shoulders in 30 consecutive patients who had a simple arthroscopic biceps tendon release were reviewed. Data was collected according to the method of the American Shoulder and Elbow Surgeons (ASES) shoulder evaluation form. Outcome was assessed with the rating system of the ASES. The mean ASES shoulder score was 81.8. There was a significant reduction in pain and improvement in function after the procedure. The complication rate was 13.3%. Bicipital pathology is a significant cause of morbidity around the shoulder. The results of this study demonstrate that functional outcome as measured by the ASES scoring system can be very good with an arthroscopic biceps tendon release for the treatment of biceps tendon pathology. (J Shoulder Elbow Surg 2001;10:247-9.)

Introduction

The initial treatment of biceps tendon pathology is generally nonoperative. If conservative treatment fails, a variety of tenodesis techniques1, 2, 4, 5, 7 have historically been used as the surgical treatments of choice. Most reports demonstrate adequate short-term results,1, 5 although the long-term results have been questioned.1, 2, 4

The concept of simple biceps tenotomy was initially proposed by Walch as an associated procedure to attempted repairs of massive rotator cuff tears. To our knowledge, there have been no studies that have reported on release of the long head of the biceps tendon for the primary treatment of biceps tendon tearing, tendon instability, or recalcitrant tenosynovitis. The purpose of this study was to report the results of simple tendon release for the treatment of pathology of the long head of the biceps brachii.

Section snippets

Materials and methods

The cases of 32 shoulders in 32 consecutive patients who had an arthroscopic biceps tendon release for the treatment of bicipital tenosynovitis, dislocation, or partial rupture were retrospectively reviewed. A minimum follow-up of 1 year was required for entrance into the study. Two patients were not included in the study; one patient could not be located, and one patient declined to participate.

The study group consisted of 30 shoulders in 30 patients who had an arthroscopic release of the

Results

The average clinical follow-up was 19 months (range, 12 to 69 months).

Discussion

Bicipital pathology is a potential cause of morbidity around the shoulder. Untreated or undiagnosed biceps-related pathology may be a common cause of persistent pain and dysfunction after shoulder surgery for other pathologies.

As evidenced in this study, bicipital pathology seldom is seen as an isolated clinical entity. In this study, 6 (20%) shoulders had at least one previous surgery before addressing the biceps tendon. This is similar to the findings of Berlemann and Bayley,2 who reported 8

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*

Supported by Steadman Hawkins Sports Medicine Foundation.

**

Reprint requests: Richard J. Hawkins, MD, Steadman Hawkins Clinic, 181 W Meadow Dr, Suite 400, Vail, CO 81647.

*

J Shoulder Elbow Surg 2001;10:247-9.

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