Arthroscopic Biceps Tenodesis: Soft Tissue versus Bone Fixation

Young-Kyu Kim; Kyu-Hak Jung; Dong-Hyun Kim

doi:10.5763/kjsm.2014.32.2.133

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Kim, Jung, and Kim: Arthroscopic Biceps Tenodesis: Soft Tissue versus Bone Fixation

Clinical Article

Korean J Sports Med 2014;32(2):133-138.

Published online: 17 January 2014

DOI: https://doi.org/10.5763/kjsm.2014.32.2.133

Arthroscopic Biceps Tenodesis: Soft Tissue versus Bone Fixation

Young-Kyu Kim, Kyu-Hak Jung, Dong-Hyun Kim

Department of Orthopedic Surgery, Gil Hospital, Gachon University, Incheon, Korea

Correspondence: Kyu-Hak Jung Department of Orthopedic Surgery, Gil Hospital, Gachon University, 21 Namdong-daero, 774beon-gil, Namdong-gu, Incheon 405-760, Korea Tel: +82-32-460-3384, Fax: +82-32-468-5437 E-mail: jjangumom52@hanmail.net

Received 19 November 2014 Revised 21 November 2014 Accepted 24 November 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The purpose of our study was to compare the clinical results between arthroscopic bone fixation on intertubercular groove using suture anchor and soft tissue fixation at the rotaor interval for biceps tenodesis when partial tear or instability of biceps tendon accompanied with rotator cuff tear. From January 2010 to January 2012, 34 cases who were performed biceps tenodesis for partial tear or instability were enrolled in our study. Mean followup period was 30.2 months. Bone fixation using suture anchor was performed in 18 cases, and soft tissue fixation was performed in 16 cases. Clinical result was evaluated by pain visual analogue scale (VAS), Speed test, Yergason test, muscle strength, and Constant score. Pain VAS of cases with soft tissue fixation was significantly higher than that of cases with bone fixation at 6 months and final followup. Positive results for the final followup Speed and Yergason test were checked in 4 cases (25%) with soft tissue fixation and 1 (5.6%) with bone fixation. The Popeye deformity was seen in 4 cases (25%) with soft tissue fixation and 2 (11%) with bone fixation. Constant score was improved 47 to 78 in cases with soft tissue fixation and 48 to 86 in cases with bone fixation. In patient with partial tear or instability of biceps tendon accompanied with rotator cuff tear, biceps tenodesis using soft tissue fixation showed worse result compared with bone fixation because of long duration of the pain. Therefore, when performing the biceps tenodesis, bone fixation will be recommended.

Keywords: Shoulder, Biceps long head, Tenodesis, Soft tissue fixation, Bone fixation

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Fig. 1.

(A) This is an illustration figure of bony tenodesis and there are 2 strands through the biceps tendon like Z shape. There are arthroscopic findings of bony tenodesis after passing (B) and tying (C) the biceps tendon with non-absorbable sutures.

Fig. 2.

There are arthroscopic findings of soft tissue tenodesis after passing (A) and tying (B) the biceps tendon with non-ab-sorbable sutures.

Table 1.

The comparision of clinical results between bony and soft tissue tenodesis

Clinical results	Preoperative		Postoperative 6 mo		Final followup
Clinical results	Bone	Soft tissue	Bone	Soft tissue	Bone	Soft tissue
Pain VAS	5.3	5.2	1.6^∗	2.6^∗	1.4^†	2.2^†
Td on IG			2 (11%)^‡	2 (13%)^‡	1 (5.6%)^§	2 (13%)^§
Speed test and Yergason test	14 (78%)	11 (69%)	1 (5.6%)^∥	5 (31%)^∥	1 (5.6%)^¶	4 (25%)^¶
Popeye deformity					2 (11%)^∗∗	4 (25%)^∗∗
Decreased muscle strength					1 (5.6%)^††	^† 2 (12.5%)^††
Constant score	48	47			86^‡‡	78^‡‡

VAS: visual analogue scale, Td: tenderness, IG: intertubercular groove.

^∗ Mann-Whitney U test, p=0.037;

^† p=0.043;

^‡ p=0.78;

^§ p=0.35;

^∥ p=0.042;

^¶ p=0.021;

^∗∗ p=0.65;

^†† p=0.32;

^‡‡ p=0.58.

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