Variations in subpectoral biceps tenodesis locations do not impact clinical outcomes

Area of Science:

• Orthopedic Surgery
• Shoulder Arthroscopy
• Biceps Tendon Pathology

Background:

• Biceps tenodesis is a common surgical procedure for long head of biceps brachii pathologies.
• Optimal tenodesis tunnel placement is crucial for maintaining the length-tension relationship.
• Variations in surgical approaches necessitate understanding tunnel placement's impact.

Purpose of the Study:

• To assess variations in tunnel placement during subpectoral biceps tenodesis.
• To correlate tenodesis tunnel position with patient-reported outcomes.

Main Methods:

• Retrospective case series analyzing outcomes based on tunnel location.
• Open subpectoralis biceps tenodesis procedures were reviewed.
• Tunnel position measured on postoperative Grashey radiographs.
• Correlation assessed with American Shoulder and Elbow Surgeons (ASES) scores and Visual Analog Scale (VAS).

Main Results:

• 31 patients with an average 17-month follow-up were included.
• Tunnel positions ranged from 4.20 cm to 12.61 cm (average 7.46 cm) from the superior greater tuberosity.
• Average final ASES score was 84.5 and VAS was 1.2.
• Weak correlation found between tunnel position and both ASES score (r=-0.12) and VAS (r=-0.23).

Conclusions:

• Subpectoralis biceps tenodesis is a viable treatment for biceps and superior labral pathology.
• No significant difference was found between tenodesis tunnel location and patient-reported outcomes.
• A range of tenodesis locations may achieve favorable clinical results, explaining varied surgical recommendations.