Long head of biceps tenotomy versus tenodesis: a systematic review and meta-analysis of randomized controlled trials

Abdulaziz F. Ahmed, Ammar Toubasi, Shady Mahmoud, Ghalib O. Ahmed, Mohammed Al Ateeq Al Dosari, Bashir A. Zikria

Research output: Contribution to journalReview articlepeer-review

Abstract

Objective: To compare tenotomy versus tenodesis for the treatment of long head of the biceps tendon pathologies. The primary outcome was the shoulder functional outcome. The secondary outcomes consisted of postoperative pain, elbow flexion and forearm supination strengths and postoperative complications. Methods: PubMed, MEDLINE, Google Scholar and Web of Science were searched until April 2020. Included studies were randomized controlled trials with a minimum 12 months’ follow-up. Results: Both treatments had similar improvement on the Constant–Murley score at 6 months and 12 months. However, tenotomy had a significantly lower Constant–Murley score at two years with a mean difference of −1.13 (95% confidence interval −1.9, −0.35). Furthermore, tenotomy had a risk ratio of 2.46 (95% confidence interval 1.66, 3.64) for developing Popeye’s deformity. No significant difference was detected in other functional outcomes, pain, or elbow flexion and forearm strength indices. Discussion: Tenodesis and tenotomy are both well-established techniques that similarly yield satisfactory outcomes. Despite that tenodesis had a statistically significant better Constant–Murley score at two years, this was clinically irrelevant. With the current evidence, we recommend either technique for the management of the long head of the biceps tendon pathologies. Level of evidence: Therapeutic, Level II

Original languageEnglish (US)
JournalShoulder and Elbow
DOIs
StateAccepted/In press - 2020

Keywords

  • biceps
  • Long head
  • meta-analysis
  • systematic review
  • tenodesis
  • tenotomy

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Surgery
  • Rehabilitation

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