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. 2023 Jun 24;8(2):278-281.
doi: 10.1016/j.jseint.2023.05.017. eCollection 2024 Mar.

Variations in subpectoral biceps tenodesis locations do not impact clinical outcomes

Achraf Jardaly  1   2 , Darren Barton  2 , Benjamin Catoe  2   3 , Brent A Ponce  1   2 , Michael Tucker  2 , Champ Baker Jr  2 , Champ Baker 3rd  2
Affiliations

Variations in subpectoral biceps tenodesis locations do not impact clinical outcomes

Achraf Jardaly et al. JSES Int. .

Abstract

Background: Biceps tenodesis is a common treatment for pathologies involving the long head of the biceps brachii. Given variations in surgical approach, focus has been placed on the location of the tenodesis to maintain appropriate length-tension relationship. The purpose of this study is to assess for variations in the tunnel placement in subpectoral biceps tenodesis procedures and correlation of tunnel position with patient-reported outcomes.

Methods: This is a retrospective case series of outcomes as a function of tunnel location with open subpectoralis biceps tenodesis. The location of the biceps tenodesis tunnel was measured on postoperative Grashey radiographs. Correlation between the tenodesis tunnel and postoperative American Shoulder and Elbow Surgeons (ASES) score and Visual Analog Scale (VAS) was assessed.

Results: 31 patients were included in the study with an average follow-up of 17 months. The overall tunnel position from the superior edge of the greater tuberosity ranged from 4.20 cm to 12.61 cm, with an average of 7.46 cm. Final ASES score and VAS were 84.5 and 1.2, respectively. There was only weak correlation between both ASES score and tunnel position (r = -0.12) and VAS and tunnel position (r = -0.23).

Discussion: Subpectoralis biceps tenodesis continues to be a viable treatment option for biceps and superior labral pathology. There remains no consensus on tenodesis location, and this study found no significant difference between tunnel location and patient-reported outcomes. Therefore, it is likely that a range of tenodesis locations exists in which favorable clinical results are achieved, explaining the numerous recommendations on tunnel placement.

Keywords: Biceps tenodesis; Long head of biceps; Patient-reported outcomes; Shoulder; Subpectoral biceps tenodesis; Tenodesis tunnel.

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Figures

Figure 1
Figure 1
Variations in the tunnel position by each surgeon.
Figure 2
Figure 2
Average locations of biceps tenodesis tunnel by surgeon.
Figure 4
Figure 4
American Shoulder and Elbow Surgeons Shoulder score as a function of tunnel position. Each blue circle is a patient's American Shoulder and Elbow Surgeons Shoulder score and tunnel position.
Figure 3
Figure 3
Variations in the tunnel position by each surgeon. The blue circle is the average tunnel position for each surgeon.
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