Arthroscopic proximal versus open subpectoral biceps tenodesis with arthroscopic repair of small- or medium-sized rotator cuff tears.

PURPOSE: The study was aimed to compare arthroscopic proximal biceps tenodesis and open subpectoral biceps tenodesis in repair of small or medium rotator cuff tears.

METHODS

Eighty-five patients underwent biceps tenodesis with arthroscopic repair of a rotator cuff tear, and 66 patients were followed for median of 26.8 (18-42) months with ultrasonography were reviewed. The arthroscopic biceps tenodesis group included 34 cases, and the open subpectoral biceps group included 32 cases. Patients were evaluated using visual analogue scale (VAS), American Shoulder and Elbow Surgeons (ASES), and constant scores. Rotator cuff repair and fixation of the biceps tendon were assessed by ultrasonography. Fixation failure and degree of deformity were evaluated by the pain in the bicipital groove and biceps apex distance (BAD).

RESULTS

VAS score and tenderness at the bicipital groove decreased significantly in the open subpectoral group at 3 months postoperative. In both groups, the range of motion, ASES score, and constant score increased significantly (P < 0.05). Rotator cuff retear occurred in three cases (8.8 %) in the arthroscopic group and two cases in the open subpectoral group (6.2 %). There was no significant difference in BAD between the two groups.

CONCLUSION

There was no difference between open subpectoral tenodesis and arthroscopic proximal tenodesis at the time of the final follow-up; however, open subpectoral tenodesis showed encouraging results at 3-month follow-up. This early result of subpectoral tenodesis was related to removing most part of biceps tendinitis and using intra-bicipital groove tenodesis technique.

LEVEL OF EVIDENCE: III.