ABSTRACT
PURPOSE: To compare the clinical outcomes of self-locking T-tenotomy called "tomydesis" to three different techniques of tenodesis for lesions of the long head of the biceps tendon (LHBT) associated with rotator cuff tears. HYPOTHESIS: Tomydesis could provide similar clinical outcomes than the other LHBT tenodesis techniques. METHODS: This prospective multicentre study included 77 patients who underwent rotator cuff repair concomitant with one of four surgical techniques on the LHBT. All patients had a minimum of 6-month follow-up post-operatively. Outcomes were evaluated based on the Constant score, SSV, pain on visual analogue scale, biceps-specific pain and Popeye deformity on photographs. RESULTS: There was no difference for the pain at the biceps muscle belly (p = 0.58), the bicipital groove (p = 0.69) and during resisted supination (p = 0.53), as well as for muscle cramps (p = 0.09), VAS for pain (p = 0.12) and Popeye deformity (p = 0.18). There was more pain in resisted flexion in the tomydesis group (p = 0.032), and significantly better Constant scores and SSV (< 0.001) in the patients who underwent the double lasso loop technique, but non-repairable cuff tears were most frequent in the tomydesis group. CONCLUSIONS: Tomydesis might be a reliable alternative that combines advantages of tenodesis and tenotomy. It should be considered in cases of rotator cuff tears, whose repair and healing are the key for good functional outcomes. LEVEL OF EVIDENCE: II.
Subject(s)
Arthroscopy/methods , Plastic Surgery Procedures/methods , Rotator Cuff Injuries/surgery , Tendon Injuries/surgery , Tenodesis/methods , Tenotomy/methods , Adult , Aged , Cohort Studies , Female , Follow-Up Studies , Humans , Injury Severity Score , Male , Middle Aged , Monte Carlo Method , Multiple Trauma/diagnostic imaging , Multiple Trauma/surgery , Muscle, Skeletal/injuries , Muscle, Skeletal/surgery , Observer Variation , Pain Measurement , Postoperative Care/rehabilitation , Prospective Studies , Range of Motion, Articular/physiology , Recovery of Function , Rotator Cuff Injuries/diagnostic imaging , Tendon Injuries/diagnostic imaging , Time FactorsABSTRACT
Disorders of the long head biceps tendon are among the most challenging of shoulder problems to diagnose and manage. In this Technical Note, we introduce an arthroscopic technique for proximal biceps tenodesis high in the groove at the articular margin of the humeral head using a single anchor and 2 self-cinching loops followed by 5 alternating half-hitches to secure the construct. This method is simple and enables stable fixation of the biceps tendon.
