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Review
. 2021 Oct;13(6):583-591.
doi: 10.1177/1758573220942923. Epub 2020 Jul 22.

Long head of biceps tenotomy versus tenodesis: a systematic review and meta-analysis of randomized controlled trials

Abdulaziz F Ahmed  1 , Ammar Toubasi  1 , Shady Mahmoud  2 , Ghalib O Ahmed  1 , Mohammed Al Ateeq Al Dosari  1 , Bashir A Zikria  3
Affiliations
Review

Long head of biceps tenotomy versus tenodesis: a systematic review and meta-analysis of randomized controlled trials

Abdulaziz F Ahmed et al. Shoulder Elbow. 2021 Oct.

Abstract

Objective: To compare tenotomy versus tenodesis for the treatment of long head of the biceps tendon pathologies. The primary outcome was the shoulder functional outcome. The secondary outcomes consisted of postoperative pain, elbow flexion and forearm supination strengths and postoperative complications.

Methods: PubMed, MEDLINE, Google Scholar and Web of Science were searched until April 2020. Included studies were randomized controlled trials with a minimum 12 months' follow-up.

Results: Both treatments had similar improvement on the Constant-Murley score at 6 months and 12 months. However, tenotomy had a significantly lower Constant-Murley score at two years with a mean difference of -1.13 (95% confidence interval -1.9, -0.35). Furthermore, tenotomy had a risk ratio of 2.46 (95% confidence interval 1.66, 3.64) for developing Popeye's deformity. No significant difference was detected in other functional outcomes, pain, or elbow flexion and forearm strength indices.

Discussion: Tenodesis and tenotomy are both well-established techniques that similarly yield satisfactory outcomes. Despite that tenodesis had a statistically significant better Constant-Murley score at two years, this was clinically irrelevant. With the current evidence, we recommend either technique for the management of the long head of the biceps tendon pathologies.

Level of evidence: Therapeutic, Level II.

Keywords: Long head; biceps; meta-analysis; systematic review; tenodesis; tenotomy.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
The search strategy flowchart.
Figure 2.
Figure 2.
The Cochrane risk of bias assessment.
See this image and copyright information in PMC

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