Combined, Single-Anchor Subscapularis Tendon Repair and Proximal Biceps Tenodesis Leads to Improved Function and Decreased Pain at 1 Year.

Journal: Arthroscopy, sports medicine, and rehabilitation

Volume: 6

Issue: 2

Year of Publication: 

Affiliated Institutions:  Department of Orthopedic Surgery, Huntington Hospital, Northwell Health, Donald and Barbara Zucker School Of Medicine at Hofstra, Huntington, New York, U.S.A. Lake Erie College of Osteopathic Medicine, Erie, Pennsylvania, U.S.A. Department of Orthopedic Surgery, Allegheny Health Network, Pittsburgh, Pennsylvania, U.S.A.

Abstract summary 

To evaluate the 1-year clinical outcomes of patients treated with combined proximal biceps tenodesis and repair of type II to III subscapularis tendon (SST) injuries according to Lafosse et al., using the Loop 'N' Tack (LNT) technique.All patients undergoing proximal biceps tenodesis and rotator cuff repair between March 1, 2020, and January 30, 2022, were retrospectively identified. Only patients undergoing combined proximal biceps tenodesis and repair of grade II or III SST injuries with a minimum follow-up of 1 year were included. All patients underwent combined single-anchor proximal biceps tenodesis and SST repair using the LNT technique. The following outcome scores were recorded at a final follow-up of 1 year postoperatively and compared with baseline, preoperative values: American Shoulder and Elbow Score (ASES), Single Assessment Numerical Evaluation (SANE), Veterans Rand 12 Item Health Survey (VR-12), and visual analog scale (VAS). The minimal clinically important difference (MCID) for all outcome indices was determined with a distribution-based method.A total of 41 consecutive patients were included. The MCID values for VAS pain, ASES, SANE, and VR-12 mental scores were 0.97, 8.5, 10.9, and 6.0 respectively. At 1-year final follow-up, approximately 95% (39/41) of patients exceeded the MCID for VAS pain scores, 90% (37/41) of patients for ASES scores, 85.4% (34/41) of patients for SANE scores, and 75.6% (31/41) of patients for VR-12 mental health scores. On average, ASES and SANE scores improved by 37 (preoperatively: 45.2, 1 year: 82.4, < .001) and 38 points (preoperatively: 38.0, 1 year: 75.7, < .001), respectively, while VAS scores decreased by 4 points (preoperatively: 5.49, 1 year: 1.48, < .001). Approximately 88% (36/41) of patients were satisfied at 1 year postoperatively. Treatment failure was observed in 1 patient (2.4%).Patients treated with combined, single-anchor SST repair and LNT proximal biceps tenodesis achieved significant improvements in function, high satisfaction, and low rates of reoperation at 1 year postoperatively. Additionally, 76% to 95% of patients met the MCID for VAS pain, ASES, SANE, and VR-12 mental health scores.Level IV, retrospective case series.

Authors & Co-authors:  Bartlett Klein Brancato Akhavan Paci

Study Outcome 

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Citations :  Arai R., Mochizuki T., Yamaguchi K., et al. Functional anatomy of the superior glenohumeral and coracohumeral ligaments and the subscapularis tendon in view of stabilization of the long head of the biceps tendon. J Shoulder Elbow Surg. 2010;19:58–64.
Authors :  5
Identifiers
Doi : 100920
SSN : 2666-061X
Study Population
Male,Female
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Publication Country
United States