Patient Satisfaction After Biceps Tenotomy

Abstract

Background: Biceps tenotomy and tenodesis are frequently performed for proximal biceps lesions; however, there continues to be debate as to which method is superior. This study examined patient-reported outcomes after biceps tenotomy.

Hypothesis: Biceps tenotomy in the setting of concomitant shoulder pathology is a reasonable option with high satisfaction rates and a low incidence of pain and cramping in middle-aged to older individuals.

Study design: Case series; Level of evidence, 4.

Methods: A total of 104 patients (mean age, 63.5 years; range, 40-81 years) were evaluated at the time of surgery and at a mean follow-up of 38.4 months (range, 22-57 months). Biceps tenotomy was performed as a component of more extensive shoulder surgery in all patients. Patient satisfaction, frequency of cramping and spasms, biceps pain, weakness, and cosmetic deformity were evaluated at over 1-year follow-up.

Results: Ninety-one percent of patients were satisfied or very satisfied with their surgical outcome, and 95% would have their surgery again. Three patients who reported being unsatisfied or very unsatisfied had either advanced glenohumeral arthritis or an irreparable rotator cuff tear. Cosmetic deformity occurred in 13% of patients. Twenty percent reported spasms and cramping in their biceps, and 19% reported some biceps pain; however, frequency of spasms and cramping was typically once weekly, and biceps pain was reported as severe or very severe in only 2 patients. Subjective biceps weakness was reported in 17% of patients. Age had no effect on outcome measures, and female sex was associated with less limitation and greater satisfaction after tenotomy compared with men.

Conclusion: Our results indicate that patient-reported downsides to biceps tenotomy were usually mild and/or infrequent and did not affect patient satisfaction. We conclude that biceps tenotomy is a viable option that can lead to a high rate of patient satisfaction and outcomes in middle-aged to older individuals undergoing shoulder surgery with biceps pathology.

Keywords: biceps tendon; shoulder arthroscopy; tenodesis; tenotomy.

Figure 1.

Patient-reported satisfaction after biceps tenotomy and concomitant procedure. (A) Percentage of patients reporting satisfaction. (B) Percentage of patients reporting they would have the same surgery again.

Figure 2.

Patient-reported outcomes after biceps tenotomy and concomitant procedure. (A) Pie graph depicts percentage of patients reporting biceps spasms and cramping. Bar graph displays frequency for patients with biceps spasms and cramping. (B) Pie graph depicts percentage of patients reporting pain in the biceps muscle. Bar graph displays severity for those patients with biceps pain. (C) Pie graph depicts percentage of patients reporting shoulder pain. Bar graph displays severity for those patients with shoulder pain. (D) Pie graph depicts percentage of patients reporting weakness with specific activities. Bar graph displays which activity is impaired for patients reporting weakness. (E) Pie graph depicts percentage of patients who felt their biceps limited their daily activities. Bar graph displays severity for those that felt limited in daily activities. (F) Pie graph depicts percentage of patients noticing a Popeye sign. Bar graph displays whether patients were cosmetically bothered by a Popeye sign.