Patients Have Strong Preferences and Perceptions for Biceps Tenotomy Versus Tenodesis

To evaluate what factors are important in the patients' preference and their perception of a successful surgical outcome.

A biceps-specific questionnaire was developed using a series of questions assessing current symptoms, previous knowledge of biceps tendon surgery, surgical outcome priorities, and patient demographics and administered to 100 patients with proximal biceps pathology after approval by the Institutional Review Board. The patients were asked which surgery they would prefer. A set of χ² tests were used to test the association between categorical variables. All tests were 2-sided and considered significant at P < .05.

A total of 100 patients enrolled in the study, with 49 female and 51 male patients at an average age of 49 years (range, 19 to 79 years). Of the 100 patients, 64 (64%) chose to have biceps tenodesis. Factors predictive of choosing a biceps tenodesis included female sex, and concern of cosmetic deformity and residual postoperative pain with a tenotomy (P < .05). Factors predictive of choosing a tenotomy included male sex, high level of current biciptal groove pain, and concerns regarding the use of additional hardware and longer recovery with a tenodesis (P < .05). Age, body mass index, occupation, income level, and concerns regarding postoperative strength and muscle cramping were not found to have a significant predictive effect toward either procedure.

Patient age should not be used as the sole criterion when deciding between biceps tenotomy and tenodesis. Our results can be consolidated to 5 predictive, reliable questions that will assist orthopaedic surgeons in making individualized patient-specific decisions regarding proximal biceps tendon surgery by emphasizing what factors are most important to patients for a successful surgical outcome.