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A Clinical Evaluation of a New     Arthroscopic Biceps Tenodesis                Technique                Alan M. Hirahara,...
Objective of Study• To evaluate the clinical effectiveness of a new  arthroscopic biceps tenodesis technique
Introduction• Many studies have discussed the utility of biceps  tenodesis over tenotomy• Most techniques are open, perfor...
Study Design• Case-control study• Collection period: 12/09 – 9/11• Pain scores, ASES scores taken every month for 6  month...
Study Design• Inclusions:  – All patients with proximal biceps tears requiring    tenodesis or tenotomy• Exclusions:  – an...
Patient DataStudy Group                  Control Group• 14 patients                • 9 patients• 8 male / 6 female        ...
Surgical Technique
Results                        Pain Scores                                           ASES Scores               p = NS     ...
Range of Motion                                                ROM          180          160                              ...
Results – Return to Work                               p = NS                   147.5       160.0       140.0             ...
Results – Days to Discharge                            p = NS                                         127.1        128.0  ...
Results: Failures• No patients suffered pull out of the tenodesis
Results• Statistical significant difference in:   – VAS pain scores at 3 months only   – ASES scores at 3, 5, & 6 months• ...
Discussion: vs Proximal Fixation• Other arthroscopic methods have performed tenodesis at the proximal groove  – This has r...
Discussion• Biceps tenodesis results in:    – Significantly less pain    – Significantly higher function    – But does car...
Conclusion• This new arthroscopic biceps tenodesis  technique:  – Easy  – Reproducible  – Outstanding results  – Avoids th...
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A Clinical Evaluation of a New Arthroscopic Biceps Tenodesis Technique

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Presentation at the Western Orthopaedic Association Annual Meeting 2012 - A Clinical Evaluation of a New Arthroscopic Biceps Tenodesis Technique

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A Clinical Evaluation of a New Arthroscopic Biceps Tenodesis Technique

  1. 1. A Clinical Evaluation of a New Arthroscopic Biceps Tenodesis Technique Alan M. Hirahara, M.D., FRCS(C) Private Practice Sacramento, CA USA Medical Director Team Physician ConsultantSacramento State Athletics Sacramento River Cats Oakland A’s MiLB - AAA
  2. 2. Objective of Study• To evaluate the clinical effectiveness of a new arthroscopic biceps tenodesis technique
  3. 3. Introduction• Many studies have discussed the utility of biceps tenodesis over tenotomy• Most techniques are open, performed at the proximal groove, or technically difficult arthroscopically
  4. 4. Study Design• Case-control study• Collection period: 12/09 – 9/11• Pain scores, ASES scores taken every month for 6 months – ROM measured pre-op and monthly for 3 months post – Date of discharge and date of return to work were noted
  5. 5. Study Design• Inclusions: – All patients with proximal biceps tears requiring tenodesis or tenotomy• Exclusions: – any post-operative trauma – non-compliance with physical therapy protocol
  6. 6. Patient DataStudy Group Control Group• 14 patients • 9 patients• 8 male / 6 female • 4 male / 5 female• Age range: 28 – 75 years • Age range: 42 – 80 years• Age average: 55.33 years • Age average: 61.06 years
  7. 7. Surgical Technique
  8. 8. Results Pain Scores ASES Scores p = NS p = 0.03 p=NS p = NS p = 0.01 p=NS p = 0.048.0 90.07.0 80.0 70.06.0 60.05.0 50.04.0 40.03.0 30.02.0 20.01.0 10.00.0 0.0 Pre-op 1 2 3 4 5 6 Pre-op 1 2 3 4 5 6 Month Month Month Month Month Month Month Month Month Month Month Month  Control Group: n = 9  Study Group: n = 14
  9. 9. Range of Motion ROM 180 160 Control Flexion 140 Study Flexion 120 ControlDegrees 100 Abduction 80 Study Abduction 60 Control ER 40 Study ER 20 0 Initial Visit 1 Month 2 Month 3 Month No Significant Difference Between the 2 Groups
  10. 10. Results – Return to Work p = NS 147.5 160.0 140.0 105.8 120.0 100.0Days 80.0 60.0 40.0 20.0 0.0 Control Group Study Group
  11. 11. Results – Days to Discharge p = NS 127.1 128.0 126.0 124.0 122.0 118.3 Days 120.0 118.0 116.0 114.0 112.0 Control Group Study Group
  12. 12. Results: Failures• No patients suffered pull out of the tenodesis
  13. 13. Results• Statistical significant difference in: – VAS pain scores at 3 months only – ASES scores at 3, 5, & 6 months• No statistical significance in: – Return to work – Time to discharge
  14. 14. Discussion: vs Proximal Fixation• Other arthroscopic methods have performed tenodesis at the proximal groove – This has resulted in failures related to intra- groove pathology – Our technique avoids those complications
  15. 15. Discussion• Biceps tenodesis results in: – Significantly less pain – Significantly higher function – But does carry a risk of conversion to tenotomy if pull out occurs• However, this simple arthroscopic technique is easy, reproducible and yields outstanding results compared with tenotomy• Will require a randomized controlled trial to confirm the results
  16. 16. Conclusion• This new arthroscopic biceps tenodesis technique: – Easy – Reproducible – Outstanding results – Avoids the complications of proximal fixation or open tenodesis
  17. 17. Thank You

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