Boileau, Am J Sports Med 2009 - Arthroscopic Treatment of Isolated Type II SLAP Lesions: Biceps Tenodesis as an Alternative to Reinsertion - Article Summary

Arthroscopic Treatment of Isolated Type II SLAP Lesions: Biceps Tenodesis as an Alternative to Reinsertion

Boileau, Bicknell, et al.·Am J Sports Med·2009·368 citations·Prospective cohort

Background

Overhead athletes report an inconsistent return to their previous level of sport and satisfaction after arthroscopic SLAP lesion repair.

Purpose

Hypothesis: Arthroscopic biceps tenodesis offers a viable alternative to the repair of an isolated type II SLAP lesion.

Methods

Study Design: Cohort study; Level of evidence, 3.

25 consecutive patients operated for an isolated type II SLAP lesion between 2000 and 2004 were evaluated at a mean of 35 months postoperatively (range, 24-69).
Patients with associated instability, rotator cuff rupture, posterosuperior impingement, or previous shoulder surgery were excluded.
10 patients (10 men) with an average age of 37 years (range, 19-57) had a SLAP repair performed with suture anchors.
15 patients (9 men and 6 women) with an average age of 52 years (range, 28-64) underwent arthroscopic biceps tenodesis performed with an absorbable interference screw.
Arthroscopic diagnosis and treatment were performed by a single experienced shoulder surgeon, and all patients were reviewed by an independent examiner.

Results

In the repair group, the Constant score improved from 65 to 83 points; however, 60% (6 of 10) of the patients were disappointed because of persistent pain or inability to return to their previous level of sports participation.
In the tenodesis group, the Constant score improved from 59 to 89 points, and 93% (14/15) were satisfied or very satisfied.
13 patients (87%) were able to return to their previous level of sports participation following biceps tenodesis, compared with only 20% (2 of 10) after SLAP repair (P = .01).
4 patients with failed SLAP repairs underwent subsequent biceps tenodesis, resulting in a successful outcome and a full return to their previous level of sports activity.

Conclusions

Arthroscopic biceps tenodesis can be considered an effective alternative to the repair of a type II SLAP lesion, allowing patients to return to a presurgical level of activity and sports participation.

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Arthroscopic Treatment of Isolated Type II SLAP Lesions: Biceps Tenodesis as an Alternative to Reinsertion.

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Arthroscopic Treatment of Isolated Type II SLAP Lesions: Biceps Tenodesis as an Alternative to Reinsertion

Boileau, Bicknell, et al.·Am J Sports Med·2009·368 citations·Prospective cohort

DOI·PubMed

Background

Overhead athletes report an inconsistent return to their previous level of sport and satisfaction after arthroscopic SLAP lesion repair.

Purpose

Hypothesis: Arthroscopic biceps tenodesis offers a viable alternative to the repair of an isolated type II SLAP lesion.

Methods

Study Design: Cohort study; Level of evidence, 3.

25 consecutive patients operated for an isolated type II SLAP lesion between 2000 and 2004 were evaluated at a mean of 35 months postoperatively (range, 24-69).
Patients with associated instability, rotator cuff rupture, posterosuperior impingement, or previous shoulder surgery were excluded.
10 patients (10 men) with an average age of 37 years (range, 19-57) had a SLAP repair performed with suture anchors.
15 patients (9 men and 6 women) with an average age of 52 years (range, 28-64) underwent arthroscopic biceps tenodesis performed with an absorbable interference screw.
Arthroscopic diagnosis and treatment were performed by a single experienced shoulder surgeon, and all patients were reviewed by an independent examiner.

Results

In the repair group, the Constant score improved from 65 to 83 points; however, 60% (6 of 10) of the patients were disappointed because of persistent pain or inability to return to their previous level of sports participation.
In the tenodesis group, the Constant score improved from 59 to 89 points, and 93% (14/15) were satisfied or very satisfied.
13 patients (87%) were able to return to their previous level of sports participation following biceps tenodesis, compared with only 20% (2 of 10) after SLAP repair (P = .01).
4 patients with failed SLAP repairs underwent subsequent biceps tenodesis, resulting in a successful outcome and a full return to their previous level of sports activity.

Conclusions

Background

Overhead athletes report an inconsistent return to their previous level of sport and satisfaction after arthroscopic SLAP lesion repair.

Purpose

Hypothesis: Arthroscopic biceps tenodesis offers a viable alternative to the repair of an isolated type II SLAP lesion.

Methods

Study Design: Cohort study; Level of evidence, 3.

25 consecutive patients operated for an isolated type II SLAP lesion between 2000 and 2004 were evaluated at a mean of 35 months postoperatively (range, 24-69).
Patients with associated instability, rotator cuff rupture, posterosuperior impingement, or previous shoulder surgery were excluded.
10 patients (10 men) with an average age of 37 years (range, 19-57) had a SLAP repair performed with suture anchors.
15 patients (9 men and 6 women) with an average age of 52 years (range, 28-64) underwent arthroscopic biceps tenodesis performed with an absorbable interference screw.
Arthroscopic diagnosis and treatment were performed by a single experienced shoulder surgeon, and all patients were reviewed by an independent examiner.

Results

In the repair group, the Constant score improved from 65 to 83 points; however, 60% (6 of 10) of the patients were disappointed because of persistent pain or inability to return to their previous level of sports participation.
In the tenodesis group, the Constant score improved from 59 to 89 points, and 93% (14/15) were satisfied or very satisfied.
13 patients (87%) were able to return to their previous level of sports participation following biceps tenodesis, compared with only 20% (2 of 10) after SLAP repair (P = .01).
4 patients with failed SLAP repairs underwent subsequent biceps tenodesis, resulting in a successful outcome and a full return to their previous level of sports activity.

Conclusions

Background

Overhead athletes report an inconsistent return to their previous level of sport and satisfaction after arthroscopic SLAP lesion repair.

Purpose

Hypothesis: Arthroscopic biceps tenodesis offers a viable alternative to the repair of an isolated type II SLAP lesion.

Methods

Study Design: Cohort study; Level of evidence, 3.

25 consecutive patients operated for an isolated type II SLAP lesion between 2000 and 2004 were evaluated at a mean of 35 months postoperatively (range, 24-69).
Patients with associated instability, rotator cuff rupture, posterosuperior impingement, or previous shoulder surgery were excluded.
10 patients (10 men) with an average age of 37 years (range, 19-57) had a SLAP repair performed with suture anchors.
15 patients (9 men and 6 women) with an average age of 52 years (range, 28-64) underwent arthroscopic biceps tenodesis performed with an absorbable interference screw.
Arthroscopic diagnosis and treatment were performed by a single experienced shoulder surgeon, and all patients were reviewed by an independent examiner.

Results

In the repair group, the Constant score improved from 65 to 83 points; however, 60% (6 of 10) of the patients were disappointed because of persistent pain or inability to return to their previous level of sports participation.
In the tenodesis group, the Constant score improved from 59 to 89 points, and 93% (14/15) were satisfied or very satisfied.
13 patients (87%) were able to return to their previous level of sports participation following biceps tenodesis, compared with only 20% (2 of 10) after SLAP repair (P = .01).
4 patients with failed SLAP repairs underwent subsequent biceps tenodesis, resulting in a successful outcome and a full return to their previous level of sports activity.