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Revision Subpectoral Biceps Tenodesis Demonstrates a High Patient Satisfaction and Good Functional Outcomes.

Christopher Clinker1, Samuel K Simister1, Logan Thomas1

  • 1Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah, U.S.A.

Arthroscopy, Sports Medicine, and Rehabilitation
|September 25, 2023
PubMed
Summary

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Revision subpectoral biceps tenodesis offers a viable solution for persistent pain after initial proximal biceps tenodesis. This procedure demonstrates high patient satisfaction and good functional outcomes, even with some residual discomfort.

Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Upper Extremity Reconstruction

Background:

  • Proximal biceps tenodesis is a common procedure for managing various shoulder pathologies.
  • Clinical failure of primary biceps tenodesis can lead to persistent pain and functional deficits.
  • Revision surgery is often considered to address failed primary procedures.

Purpose of the Study:

  • To clinically evaluate the outcomes of revision subpectoral biceps tenodesis in patients with failed primary proximal biceps tenodesis.
  • To assess functional recovery, pain levels, and patient satisfaction following revision surgery.

Main Methods:

  • Retrospective case series of patients undergoing revision subpectoral biceps tenodesis.
  • Inclusion criteria: minimum 2-year follow-up post-revision, primary tenodesis failure.

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  • Exclusion criteria: concomitant procedures like revision rotator cuff repair.
  • Outcome measures: Simple Shoulder Test (SST), American Shoulder and Elbow Surgeons (ASES) score, visual analog scale (VAS) for pain, subjective reports of weakness and satisfaction.

    • Main Results:

    • 11 out of 14 eligible patients (78.5%) completed the minimum 2-year follow-up (mean 8.1 years).
    • Postoperative functional outcomes included mean active forward elevation of 159° and external rotation of 47°.
    • Mean follow-up scores: ASES 79, SST 11, VAS pain 2.6.
    • All 11 patients reported satisfaction and willingness to undergo the procedure again.

    Conclusions:

    • Revision subpectoral biceps tenodesis is a viable surgical option for managing persistent pain after primary proximal biceps tenodesis.
    • The procedure yields high patient satisfaction and favorable functional outcomes, despite potential for some residual pain.
    • This study supports the use of revision subpectoral biceps tenodesis in select patient populations.