Subpectoral tenodesis of the long head of the biceps tendon with an interference screw and acortical button : Clinical and cosmetic results after 1 year

Abstract

Pathologies of the long head of biceps tendon (LHB) can cause anterior shoulder pain. Surgical treatment includes tenotomy and tenodesis (TD), however TD causes fewer cosmetic deformities and less cramping of the biceps muscle. To date, numerous techniques for TD have been described but the "gold standard" has not yet been established. The purpose of this study is to evaluate the functional and cosmetic outcome following subpectoral biceps TD with an interference screw and acortical-button (STLHB-IC) after 1year. 35patients (10female, 25male) with an average age of 57.4± 7 years were examined after STLHB-IC with afollow up of 12.8± 1.2months. The constant score (CS), the long head of biceps score (LHBS) and the subjective shoulder value (SSV) were assessed. Furthermore, the cosmetic result was evaluated by the patient and the examiner, and the elbow flexion strength (EFS) was measured. The CS (82.5± 17.2), LHBS (90.1± 11.5) and SSV (83.2± 17.7) showed good and excellent results. The SSV increased significantly pre vs. postoperatively (40.6± 19.7 vs. 83.2± 17.7). The CS (82.5± 17.2) and the LHBS (90.1± 11.5), as well as the EFS (17.5± 4.8 kg) of the affected shoulder revealed no significant differences compared with the non-affected shoulder (CS: 91.8± 11.3, LHBS: 99.1± 11.5; EFS: 19.7± 4.8). Severe Popeye deformities (measured by LHBS) were found in 6% of the cases, however if they occurred patients (13.4± 3.8) evaluated them as significantly less disadvantageous than the examiners (11.9± 4.7). There were no neurovascular injuries, infections or fractures. STLHB-IC is asafe, reproducible technique with convincing functional and cosmetic results that provides high patient satisfaction.