Open subpectoral vs. arthroscopic proximal biceps tenodesis: A comparison study of clinical outcomes

The purpose of the present study was to compare the results of open subpectoral biceps tenodesis and arthroscopic proximal biceps tenodesis for treating long head of biceps (LHB) lesions. From January 2015 to June 2016, a total of 259 patients underwent LHB tenodesis surgery. Among them, 117 patients (60 females and 57 males) who met the inclusion and exclusion criteria were enrolled into the present study and were randomly divided into two groups, including an open subpectoral tenodesis group (OSPBT; n=62) and an arthroscopic proximal tenodesis group (ASPBT; n=55). All patients were followed up for at least 12 months. The demographic characteristics of each patient were recorded in detail. Moreover, clinical examinations of LHB lesions, such as shoulder range of motion (ROM), Visual Analog Scale (VAS) scores (0, no pain, to 10, most severe pain), American Shoulder and Elbow Surgeons (ASES) scores, and Constant-Murley shoulder outcome scores, were investigated prior to surgery, as well as 3, 6 and 12 months after surgery. Postoperative complications were also comprehensively investigated. There were no significant differences in sex, body mass index, dominant shoulder, duration of pain, injury type and operation time between the groups. The mean length of hospital stay in the ASPBT group was significantly lower than that of the OSPBT group (5.4±1.8 days vs. 9.3±2.9 days; P<0.05). The clinical outcomes, including shoulder ROMs, VAS scores, ASES scores and Constant-Murley shoulder outcome scores, were significantly improved after either OSPBT or ASPBT treatment. Specifically, the VAS score, incidence of postoperative stiffness and bicipital groove tenderness in the OSPBT group were significantly lower than those in the ASPBT group at 3 months post-surgery (P<0.05). Additionally, there were no significant difference in the improvement of other clinical outcomes and postoperative complications between the two groups. ASPBT and OSPBT were both effective and safe techniques for treating LHB lesions. However, tenderness of the bicipital groove was more common in the early stages of recovery post-surgery in the ASPBT group, which may be related to tendinitis of the LHB in the bicipital groove.