Clinical and isokinetic comparison between tenotomy and tenodesis in biceps pathologies.

Objectives: The purpose of this study to compare clinical and isokinetic results of patients who underwent biceps tenotomy or tenodesis for chronic tenosynovitis.

Methods: Arthroscopic biceps tenotomy, arthroscopy assisted or arthroscopic biceps tenodesis were done in 20 patients who had diagnosis of chronic tenosynovitis and in whom conservative treatment was not helpful. Rotator cuff repair and acromioplasty was performed in 18 patients and acromioplasty alone in two patients in addition to biceps surgery. Arthroscopic biceps tenotomy was done in 10 patients (5 female, 5 male; mean age 63, range 53-75), 10 patients underwent tenodesis out of which arthroscopy assisted biceps tenodesis was done in 8 patients and all arthroscopic biceps tenodesis was done in 2 patients (4 female, 6 male; mean age 57, range 49-66). All patients were evaluated with Constant and UCLA scores preoperatively and postoperatively. The average follow-up of the patients 3,1 years (between 1-8 years). Isokinetically elbow flexion and forearm supination were compared using the Cybex (Biodex 3, Cybex Biomedical System, NY, USA) machine. Pre-operative results of each group were compared with the postoperative results, using Mann-Whitney U test.

Results: Preoperative average constant scores of tenotomy group were 64.40, whereas postoperative scores were 89.50 (p=0.002), and preoperative average constant scores of tenodesis group were 62.80, whereas postoperative scores were 86.70 (p=0.003). Preoperative average UCLA scores of tenotomy group were 23.20 whereas postoperative UCLA scores 22.60 (p=0.003), preoperative average UCLA scores of tenodesis group were 30.00 whereas postoperative UCLA scores was 29.20 (p=0.004). In both groups statistically significant improvement of UCLA and Constant scores was detected. Comparison between Constant, UCLA scores and isokinetic measurements of both groups showed no statistically significant difference (p>0.05). No complication was noted.

Conclusion: In the treatment of chronic tenosynovitis, biceps tenodesis and tenotomy of long head of biceps showed similar clinical, functional, isokinetic and cosmetic results. No Popeye deformity was seen in the tenotomy group.