Suprapectoral Mini-Open Biceps Tenodesis - Functional and Sonographic Results

Background: Aim of this study was to evaluate the effectiveness of a suprapectoral mini-open tenodesis of the long head of the biceps (LHB) tendon with ultrasound assessment. Secondary aim was to compare the results of an extraosseous fixation (group I) to those of an intraosseous fixation technique (group II). Patients and Methods: 25 patients (10 female, 15 male) aged 54 +/- 8 (36 to 68) years were followed-up 21 +/- 4.7 (13 to 32) months postoperatively. Tenodesis fixation was extraosseous in 12 (group I) and intraosseous in 13 patients (group II). Preoperative shoulder function and intraoperative findings were recorded. At the time of follow-up the fixation of the biceps tendon was evaluated by ultrasound examination. Furthermore, the shoulder function, the simple shoulder test (SST), the Constant-Murley score (CMS) and the "long head of the biceps (LHB) score" were assessed. Results: Failure of tenodesis fixation was observed in 3/12 cases (25%) of group I and 1/13 cases (8%) of group II. Shoulder flexion (p < 0.001), abduction (p < 0.001), external rotation (p < 0.001) and the pain level (p < 0.001) improved significantly compared to the preoperative status. At time of follow-up the CMS averaged 79.4 +/- 13 points, the age and gender related CMS averaged 95.7 +/- 16.4%. Mean SST was 10.6 +/- 2.1 points. No significant difference (p = 0.064) could be observed between the LHB of the affected (88.1 +/- 9.7) versus the non-affected shoulder (92.7 +/- 13.6 points). Age and gender related CMS (p = 0.96), LHB score (p = 0.16) and SST (p = 0.94) of both groups revealed no significant differences. Conclusion: The intraosseous fixation technique seems favourable with less fixation failure compared to the extraosseous suspension technique. The suprapectoral mini-open tenodesis of the LHB is a valuable alternative tenodesis technique with good to excellent clinical results.