Arthroscopic Onlay Suprapectoral Bicipital Tenodesis Using Suture Anchor; A Prospective Cohort Study

Abstract

Background: The long head of the biceps (LHB) tendon was assumed to be a common source of anterior shoulder pain. The inflammatory pathogenesis was considered to be the commonest. Different modalities of treatment were assigned, including conservative, physical therapy, and surgical. Biceps tenotomy and tenodesis were considered the commonest surgical techniques.

Methods: We performed a prospective cohort study on 23 patients who presented with anterior shoulder pain due to pathology in the LHB from June 2019 to December 2021. participants were recruited for arthroscopic suprapectoral tenodesis and followed up at two endpoints; six and 12 months. To detect the clinical and functional outcomes, we used the Constant-Murley score, which included four domains pain, strength, range of motion, and Activities of daily living. Also, we calculated the incidence of the Popeye sign, which represented the rupture of LHB. Results: Patients could have a significant improvement in the Constant-Murley score postoperatively at both six and 12 months compared with the preoperative values, with a postoperative mean of 82.3 (78 - 88) at six months and 85.13 (80 - 91) at 12 months. Also, they achieved significant improvement in each of its components; pain, ADL, stability, and motility at six months compared with the baseline values. Additionally, only three patients developed the Popeye sign. Conclusion: The suprapectoral tenodesis was an effective procedure in the treatment of the pain of the LHB tendon with few side effects. It could significantly improve the Constant-Murley score at both six months and one year.