AAOS2017: Similar short-term function & cosmesis in tenodesis vs tenotomy for LHBT lesions

Study Type: Randomized Trial
OE Level of Evidence: N/A
Journal Level of Evidence: N/A
CONFERENCE ACE REPORTS
This ACE Report is a summary of a conference presentation or abstract. The information provided has limited the ability to provide an accurate assessment of the risk of bias or the overall quality. Please interpret the results with caution as trials may be in progress and select results may have been presented.
Synopsis
112 patients scheduled for arthroscopic management of a lesion of the long head of biceps brachii tendon were randomized to undergo either tenodesis or tenotomy. Follow-up was planned for 24 months postoperative, and outcomes reported included the American Shoulder and Elbow Surgeons Score and cosmetic outcome. Based on available Please login to view the rest of this report. Please login to view the rest of this report.
Why was this study needed now?
Tenodesis or tenotomy can be used in the operative management of lesions of the long head of biceps brachii tendon. Tenodesis is technically more demanding, though has been cited to provide better strength and avoid deformity postoperatively. Tenotomy is favoured by some due to its relatively lower technical demand and easier rehabilitation. A majority of the debate is based on anecdotal evidence and opinion, as few high-quality randomized controlled trials have been performed.
What was the principal research question?
In arthroscopic surgery for a lesion of the long head of biceps brachii tendon, is there any significant difference between tenotomy and tenodesis in patient-reported function, cosmetic deformity, operative time, or incidence of complications and revision when assessed over the first 12 months postoperatively?
Population: 112 patients scheduled for arthroscopic surgery to address a lesion of the long head of biceps brachii tendon.
Intervention: Tenodesis: Arthroscopically, the long head of biceps brachii tendon was mobilized, and fixed within the bicipital groove or at the inferior border of the pectoralis major. (n=56)
Comparison: Tenotomy group: Arthroscopically, the long head of biceps brachii tendon was released. (n=56)
Outcomes: The primary outcome was the American Shoulder and Elbow Surgeons (ASES) score. Secondary outcomes included operative time, cosmetic outcome, the incidence of complications, the incidence of revision, and tendon integrity on MRI.
Methods: RCT
Time: Follow-up was scheduled for 3, 6, 12, and 24 months postoperatively.
What were the important findings?
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What should I remember most?
How will this affect the care of my patients?
The authors responsible for this critical appraisal and ACE Report indicate no potential conflicts of interest relating to the content in the original publication.
Rick Houben
April 10, 2017
Orthopaedic Surgeon - Belgium
What was the average age in each group?