This document provides information about a new arthroscopic biceps tenodesis technique. It summarizes a study comparing 14 patients who underwent the new technique to 9 patients who had a biceps tenotomy. The new technique resulted in significantly less pain and higher function scores at various points as measured by questionnaires, though it carries a small risk of needing to be converted to a tenotomy if the fixation pulls out. The technique was found to be easy to perform and yielded better outcomes than tenotomy while avoiding complications of proximal fixation methods.
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Proximal Biceps
1. Biceps: Below the Groove
Alan M. Hirahara, M.D., FRCS(C)
Board Certified in Orthopaedic Surgery & Orthopaedic Sports Medicine
Specializing in arthroscopic shoulder surgery
Medical Director Team Physician Consultant
Sacramento State Athletics Sacramento River Cats Oakland Aβs
MiLB - AAA
4. A Clinical Evaluation of a New
Arthroscopic Biceps Tenodesis
Technique
Alan M Hirahara, MD, FRCSC
*Presented @ AANA, WOA, & COA 2012
5. Study Design
β’ Case-control study design
β’ 14 patients with Biceps Tenodesis / 9 patients with Tenotomy
β’ Collection period: 12/09 β 9/11
β’ Pain scores, ASES scores taken every month for 6 months
β ROM measured pre-op and monthly for 3 months post
β Date of discharge and date of return to work noted
7. Results
Pain Scores ASES Scores
p = NS p = 0.03 p=NS p = NS p = 0.01 p=NS p = 0.04
8.0 90.0
7.0 80.0
70.0
6.0
60.0
5.0
50.0
4.0
40.0
3.0
30.0
2.0
20.0
1.0 10.0
0.0 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
ο Control Group: n = 9
ο Study Group: n = 14
8. Results
β’ No pull-outs of tenodesis
β’ Statistical significant difference in:
β VAS pain scores at 3 months only
β ASES scores at 3, 5, & 6 months
β’ No statistical significance in:
β Return to work
β Time to discharge
9. Conclusion
β’ Biceps tenodesis results in:
β Significantly less pain
β Significantly higher function
β But does carry a risk of conversion to tenotomy if pull out occurs
β’ However, this simple arthroscopic technique is easy, reproducible
and yields outstanding results compared with tenotomy
β’ Avoids complications associated with proximal fixation