Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2015 Mar 18;10(3):e0121286.
doi: 10.1371/journal.pone.0121286. eCollection 2015.

Tenotomy or tenodesis for the long head of biceps lesions in shoulders: a systematic review and meta-analysis

Affiliations
Meta-Analysis

Tenotomy or tenodesis for the long head of biceps lesions in shoulders: a systematic review and meta-analysis

Heng'an Ge et al. PLoS One. .

Abstract

Background: Both tenotomy and tenodesis have been widely used for the treatment of long head of biceps tendon (LHBT) lesions, but the optimal strategy remains considerably controversial. In this meta-analysis of published studies, we compared the results of the two procedures.

Methods: A literature search that compared tenotomy with tenodesis was performed using MEDLINE, and Embase until August 2014. A total of 7 studies reporting data on 622 subjects were included. Study quality was evaluated using the PEDro critical appraisal tool and the NO quality assessment tool.

Results: Data synthesis showed higher functional outcomes, a lower complication rate, and longer surgical time in patients managed with tenodesis compared to tenotomy (Constant score, P = 0.02; Popeye sign, P < 0.001; cramp pain, P = 0.04; surgical time, P < 0.001, respectively).

Conclusion: This meta-analysis indicates that tenodesis results in better arm function and lower incidences of cramp pain and Popeye sign in LHBT lesions, while the procedure required longer surgical time compared to tenotomy. More sufficiently powered studies would be required to further determine the optimal strategy.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow diagram of study selection.
Fig 2
Fig 2. Forest plot to assess Constant score between two treatment strategies.
Fig 3
Fig 3. Secondary outcomes after meta-analysis.
A Forest plot to assess cramps pain events between two treatment strategies. B Forest plot to assess Popeye sign events between two treatment strategies. C Forest plot to assess patient’s satisfaction events between two treatment strategies. D Forest plot to assess surgical time events between two treatment strategies.

References

    1. Delle Rose G, Borroni M, Silvestro A, Garofalo R, Conti M, et al. (2012) The long head of biceps as a source of pain in active population: tenotomy or tenodesis? A comparison of 2 case series with isolated lesions. Musculoskelet Surg 96 Suppl 1: S47–52. 10.1007/s12306-012-0189-0 - DOI - PubMed
    1. Rodosky MW, Harner CD, Fu FH (1994) The role of the long head of the biceps muscle and superior glenoid labrum in anterior stability of the shoulder. Am J Sports Med 22: 121–130. - PubMed
    1. Yamaguchi K, Riew KD, Galatz LM, Syme JA, Neviaser RJ (1997) Biceps activity during shoulder motion: an electromyographic analysis. Clin Orthop Relat Res: 122–129. - PubMed
    1. Kim SH, Ha KI, Kim HS, Kim SW (2001) Electromyographic activity of the biceps brachii muscle in shoulders with anterior instability. Arthroscopy 17: 864–868. - PubMed
    1. Itoi E, Kuechle DK, Newman SR, Morrey BF, An KN (1993) Stabilising function of the biceps in stable and unstable shoulders. J Bone Joint Surg Br 75: 546–550. - PubMed

LinkOut - more resources