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. 2020 May 31;4(3):632-637.
doi: 10.1016/j.jseint.2020.03.012. eCollection 2020 Sep.

Intra-articular arthroscopic biceps tenodesis with interference screw: clinical and isokinetic evaluation

Márcio Schiefer  1 , Victor Cossich  2   3 , Gláucio Siqueira  4 , Martim Teixeira Monteiro  4 , Luiz Felipe Nery  4 , Geraldo Motta  4
Affiliations

Intra-articular arthroscopic biceps tenodesis with interference screw: clinical and isokinetic evaluation

Márcio Schiefer et al. JSES Int. .

Abstract

Background: Although biceps tenodesis has been widely used to treat its pathologies, few studies looked at the objective evaluation of elbow strength after this procedure. The purpose of this study is to clinically evaluate patients submitted to long head of the biceps (LHB) tenodesis with interference screws through an intra-articular approach and analyze the results of an isokinetic test to measure elbow flexion and forearm supination strengths.

Methods: Patients who had biceps tenodesis were included in the study if they had a minimum follow-up of 24 months. Patients were excluded if they had concomitant irreparable cuff tears or previous or current contralateral shoulder pain or weakness. Postoperative evaluation was based on University of California-Los Angeles (UCLA) shoulder score and on measurements of elbow flexion and supination strength, using an isokinetic dynamometer. Tests were conducted in both arms, with velocity set at 60º/s with 5 concentric-concentric repetitions.

Results: Thirty-three patients were included and the most common concomitant diagnosis were rotator cuff tear (69%) and superior labrum anterior to posterior (SLAP) lesions (28%). The average UCLA score improved from 15.1 preoperatively to 31.9 in the final follow-up (P < .001). Isokinetic tests showed no difference in peak torque between the upper limbs. One patient had residual pain in the biceps groove. None of the patients had Popeye deformity. UCLA score and follow-up length did not demonstrate correlation with peak torque.

Conclusion: Arthroscopic proximal biceps tenodesis with interference screw, close to the articular margin, yielded good clinical results. Isokinetic tests revealed no difference to the contralateral side in peak torque for both supination and elbow flexion.

Keywords: Shoulder; arthroscopy; biceps tendon; elbow strength; isokinetic evaluation; tenodesis.

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Figures

Figure 1
Figure 1
Right shoulder, superolateral view. (A) Biceps tendon is exposed through the anterior portal and held with a clamp. (B) Krackow suture is made and the tendon diameter is measured.
Figure 2
Figure 2
A bone socket is made using a cannulated drill.
Figure 3
Figure 3
Biceps tendon is placed inside the bone socket and interference screw slides through the driver into the bone socket.
Figure 4
Figure 4
UCLA scores measured in pre- and postsurgery (mean ± SD). UCLA, University of California–Los Angeles functional scale; Pre, presurgery; Post, postsurgery; SD, standard deviation. ∗Significantly different from presurgery score (P < .001, d = 4.04).
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