Complications of biceps tenodesis based on location, fixation, and indication: a review of 1526 shoulders

Christopher L McCrum, R. Kiran Alluri, Michael Batech, Raffy Mirzayan

Research output: Contribution to journalArticle

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Abstract

Background: Long head of the biceps tendon (LHBT) tenodesis is predominantly performed for 2 reasons: anterior shoulder pain (ASP) or structural reasons (partial tear, dislocation). Methods: Between 2006 and 2014, all cases of primary LHBT tenodesis performed at an integrated health care system were retrospectively reviewed. Complications were analyzed by tenodesis location (below or out of the groove [OOG] vs leaving tendon in the groove [ITG]), fixation method (soft tissue vs implant), and indication (preoperative ASP vs structural). Results: Among 1526 shoulders, persistent ASP did not differ by fixation method (11.0% for implant vs 12.8% for soft tissue, P =.550) or location (10.8% for OOG vs 12.9% for ITG, P =.472). Soft-tissue tenodesis cases had more frequent new-onset ASP (11.9% vs 2.6%, P <.001) and subjective weakness (8.50% vs 3.92%, P <.001) but less frequent revisions (0% vs 1.19%, P =.03) than implant tenodesis cases. No difference was found between ITG and OOG for persistent ASP (12.9% vs 10.8%, P =.550), new-onset ASP (6.5% vs 2.8%, P =.339), cramping (1.70% vs 2.31%, P =.737), deformity (4.72% vs 4.62%, P =.532), or subjective weakness (6.23% vs 4.32%, P =.334), but ITG cases had more revisions (1.51% vs 0.60%, P =.001). Among implant tenodesis cases, 1 shoulder (0.085%) sustained a fracture. Conclusion: The overall complication rate of LHBT tenodesis was low. Of the shoulders, 10.8% to 12.9% continued to have ASP, regardless of whether the LHBT was left ITG. Soft-tissue tenodesis cases had higher rates of new-onset ASP and subjective weakness. No significant difference for tenodesis ITG or OOG was found in biceps-related complications.

Original languageEnglish (US)
JournalJournal of Shoulder and Elbow Surgery
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Tenodesis
Shoulder Pain
Tendons
Integrated Delivery of Health Care
Tears

Keywords

  • anterior shoulder pain
  • complications
  • Level III
  • long head of biceps tendon
  • Retrospective Cohort Comparison
  • Shoulder
  • subpectoral
  • suprapectoral
  • tenodesis
  • Treatment Study

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Complications of biceps tenodesis based on location, fixation, and indication : a review of 1526 shoulders. / McCrum, Christopher L; Alluri, R. Kiran; Batech, Michael; Mirzayan, Raffy.

In: Journal of Shoulder and Elbow Surgery, 01.01.2018.

Research output: Contribution to journalArticle

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title = "Complications of biceps tenodesis based on location, fixation, and indication: a review of 1526 shoulders",
abstract = "Background: Long head of the biceps tendon (LHBT) tenodesis is predominantly performed for 2 reasons: anterior shoulder pain (ASP) or structural reasons (partial tear, dislocation). Methods: Between 2006 and 2014, all cases of primary LHBT tenodesis performed at an integrated health care system were retrospectively reviewed. Complications were analyzed by tenodesis location (below or out of the groove [OOG] vs leaving tendon in the groove [ITG]), fixation method (soft tissue vs implant), and indication (preoperative ASP vs structural). Results: Among 1526 shoulders, persistent ASP did not differ by fixation method (11.0{\%} for implant vs 12.8{\%} for soft tissue, P =.550) or location (10.8{\%} for OOG vs 12.9{\%} for ITG, P =.472). Soft-tissue tenodesis cases had more frequent new-onset ASP (11.9{\%} vs 2.6{\%}, P <.001) and subjective weakness (8.50{\%} vs 3.92{\%}, P <.001) but less frequent revisions (0{\%} vs 1.19{\%}, P =.03) than implant tenodesis cases. No difference was found between ITG and OOG for persistent ASP (12.9{\%} vs 10.8{\%}, P =.550), new-onset ASP (6.5{\%} vs 2.8{\%}, P =.339), cramping (1.70{\%} vs 2.31{\%}, P =.737), deformity (4.72{\%} vs 4.62{\%}, P =.532), or subjective weakness (6.23{\%} vs 4.32{\%}, P =.334), but ITG cases had more revisions (1.51{\%} vs 0.60{\%}, P =.001). Among implant tenodesis cases, 1 shoulder (0.085{\%}) sustained a fracture. Conclusion: The overall complication rate of LHBT tenodesis was low. Of the shoulders, 10.8{\%} to 12.9{\%} continued to have ASP, regardless of whether the LHBT was left ITG. Soft-tissue tenodesis cases had higher rates of new-onset ASP and subjective weakness. No significant difference for tenodesis ITG or OOG was found in biceps-related complications.",
keywords = "anterior shoulder pain, complications, Level III, long head of biceps tendon, Retrospective Cohort Comparison, Shoulder, subpectoral, suprapectoral, tenodesis, Treatment Study",
author = "McCrum, {Christopher L} and Alluri, {R. Kiran} and Michael Batech and Raffy Mirzayan",
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T1 - Complications of biceps tenodesis based on location, fixation, and indication

T2 - a review of 1526 shoulders

AU - McCrum, Christopher L

AU - Alluri, R. Kiran

AU - Batech, Michael

AU - Mirzayan, Raffy

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Long head of the biceps tendon (LHBT) tenodesis is predominantly performed for 2 reasons: anterior shoulder pain (ASP) or structural reasons (partial tear, dislocation). Methods: Between 2006 and 2014, all cases of primary LHBT tenodesis performed at an integrated health care system were retrospectively reviewed. Complications were analyzed by tenodesis location (below or out of the groove [OOG] vs leaving tendon in the groove [ITG]), fixation method (soft tissue vs implant), and indication (preoperative ASP vs structural). Results: Among 1526 shoulders, persistent ASP did not differ by fixation method (11.0% for implant vs 12.8% for soft tissue, P =.550) or location (10.8% for OOG vs 12.9% for ITG, P =.472). Soft-tissue tenodesis cases had more frequent new-onset ASP (11.9% vs 2.6%, P <.001) and subjective weakness (8.50% vs 3.92%, P <.001) but less frequent revisions (0% vs 1.19%, P =.03) than implant tenodesis cases. No difference was found between ITG and OOG for persistent ASP (12.9% vs 10.8%, P =.550), new-onset ASP (6.5% vs 2.8%, P =.339), cramping (1.70% vs 2.31%, P =.737), deformity (4.72% vs 4.62%, P =.532), or subjective weakness (6.23% vs 4.32%, P =.334), but ITG cases had more revisions (1.51% vs 0.60%, P =.001). Among implant tenodesis cases, 1 shoulder (0.085%) sustained a fracture. Conclusion: The overall complication rate of LHBT tenodesis was low. Of the shoulders, 10.8% to 12.9% continued to have ASP, regardless of whether the LHBT was left ITG. Soft-tissue tenodesis cases had higher rates of new-onset ASP and subjective weakness. No significant difference for tenodesis ITG or OOG was found in biceps-related complications.

AB - Background: Long head of the biceps tendon (LHBT) tenodesis is predominantly performed for 2 reasons: anterior shoulder pain (ASP) or structural reasons (partial tear, dislocation). Methods: Between 2006 and 2014, all cases of primary LHBT tenodesis performed at an integrated health care system were retrospectively reviewed. Complications were analyzed by tenodesis location (below or out of the groove [OOG] vs leaving tendon in the groove [ITG]), fixation method (soft tissue vs implant), and indication (preoperative ASP vs structural). Results: Among 1526 shoulders, persistent ASP did not differ by fixation method (11.0% for implant vs 12.8% for soft tissue, P =.550) or location (10.8% for OOG vs 12.9% for ITG, P =.472). Soft-tissue tenodesis cases had more frequent new-onset ASP (11.9% vs 2.6%, P <.001) and subjective weakness (8.50% vs 3.92%, P <.001) but less frequent revisions (0% vs 1.19%, P =.03) than implant tenodesis cases. No difference was found between ITG and OOG for persistent ASP (12.9% vs 10.8%, P =.550), new-onset ASP (6.5% vs 2.8%, P =.339), cramping (1.70% vs 2.31%, P =.737), deformity (4.72% vs 4.62%, P =.532), or subjective weakness (6.23% vs 4.32%, P =.334), but ITG cases had more revisions (1.51% vs 0.60%, P =.001). Among implant tenodesis cases, 1 shoulder (0.085%) sustained a fracture. Conclusion: The overall complication rate of LHBT tenodesis was low. Of the shoulders, 10.8% to 12.9% continued to have ASP, regardless of whether the LHBT was left ITG. Soft-tissue tenodesis cases had higher rates of new-onset ASP and subjective weakness. No significant difference for tenodesis ITG or OOG was found in biceps-related complications.

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KW - Level III

KW - long head of biceps tendon

KW - Retrospective Cohort Comparison

KW - Shoulder

KW - subpectoral

KW - suprapectoral

KW - tenodesis

KW - Treatment Study

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