Biceps tenotomy has earlier pain relief compared to biceps tenodesis: a randomized prospective study.

Journal Article (Journal Article)

PURPOSE:  Surgical management for long head of the biceps (LHB) tendinopathy with either biceps tenotomy or tenodesis is a reliable, but debated treatment option. The aim of this prospective, randomized, single-blinded study is to evaluate differences in pain relief and subjective outcomes between biceps tenotomy versus tenodesis for LHB tendinopathy. METHODS:  Subjects were randomized and blinded to biceps tenotomy versus arthroscopic tenodesis intra-operatively. Outcomes evaluated included subjective patient outcome scores, pain, and cosmetic deformity. Subjective outcomes scores and pain were analyzed using a two-way ANOVA, controlling for concomitant rotator cuff repair. Binary outcomes were compared using Chi-square tests. RESULTS:  Thirty-four subjects (31 male, 3 female) with a median age of 56 (range 30-77) were enrolled. Twenty subjects were randomized to tenotomy and 14 to tenodesis. Fifty-six percent had concomitant rotator cuff repairs. The mean VAS pain score at 3 months was lower with tenotomy versus tenodesis. 2-year follow-up demonstrated no statistically significant differences for VAS, ASES, or SANE. 15/20 (75%) subjects with biceps tenotomy reported no pain medication use at the 2-week postoperative visit versus 5/14 (33%) for biceps tenodesis. Popeye deformity was found in 5/20 (25%) of tenotomy subjects versus 1/14 (7%) in tenodesis subjects. CONCLUSION: Outcomes appear similar between biceps tenotomy versus tenodesis; however, the tenotomy group demonstrated greater incidence of cosmetic deformity but an earlier improvement in postoperative pain. LEVEL OF EVIDENCE: Treatment Studies, Level II.

Full Text

Duke Authors

Cited Authors

  • Belay, ES; Wittstein, JR; Garrigues, GE; Lassiter, TE; Scribani, M; Goldner, RD; Bean, CA

Published Date

  • December 2019

Published In

Volume / Issue

  • 27 / 12

Start / End Page

  • 4032 - 4037

PubMed ID

  • 31486915

Electronic International Standard Serial Number (EISSN)

  • 1433-7347

Digital Object Identifier (DOI)

  • 10.1007/s00167-019-05682-1


  • eng

Conference Location

  • Germany