The IBTIS score, a new predictive score for arthroscopic biceps tenotomy

Abstract

Objectives:Shoulder pain related to long head of biceps tendinopathy is common. Surgical treatment by arthroscopic tenotomy has proven to be effective. The objective was to evaluate the preoperative clinical and radiological prognostic factors of arthroscopic tenotomy of the long head of biceps, and to establish a predictive score of good response to treatment.Methods:We conducted a retrospective single-center study including 64 patients who underwent surgery between January 2018 and March 2020 by arthroscopic LHB tenotomy, whether or not associated with tenodesis. We identified 2 groups of patients based on a clinical evaluation 3 months postoperatively, which included subjective assessment by the Single Shoulder Value (SSV), Constant, C-Test, and pain scores: a good responder group and a poor responder group. Prognostic factors for good response were then identified in the 2 groups based on questioning, clinical examination and preoperative imaging. Based on these factors, a predictive score for a good response was established.Results:All evaluation criteria showed postoperative improvement: Mean SSV (72.2 vs 50.7; p 65 years (p = 0.01), cuff tear on preoperative imaging (p = 0.01), the Cross Arm Test (p = 0.02), night-time pain (p = 0.08), Yergason’s test (p = 0.16), the Speed Test (p = 0.22). Manual labor appeared to be a factor in an unfavorable outcome (p = 0.07). These factors were incorporated into the 10-point IBTIS score. A score above 5 was associated with a favorable outcome in more than 80% of the patients (p <0.001).Conclusion:The IBTIS (Isolated Biceps Tenotomy Index Score) is a preoperative clinical and radiological score with 7 items for surgical treatment by arthroscopic tenotomy of the long head of biceps. Further studies are required to validate the prognostic accuracy.