This Level III prospective cohort compared arthroscopic biceps tenodesis against suture anchor repair for isolated type II SLAP lesions. Twenty-five patients were treated by a single surgeon and followed a mean of 35 months. It asks whether tenodesis is a viable alternative to reinsertion, especially in overhead athletes.
When an overhead athlete has an isolated type II SLAP lesion, the reflex answer for years was labral repair. This paper challenged that by showing tenodesis restored sport in ~87% versus ~20% after repair.
The authors offer a mental model for why repair fails. The superior labrum and biceps anchor normally roll medially during abduction and external rotation. A rigid suture anchor repair locks that motion and generates pain during throwing.
The biceps tendon also carries dense sensory-sympathetic innervation, so removing it as a pain generator helps. Strength was preserved after tenodesis, addressing the usual worry about biceps takedown.
Watch the major limitation: the groups differed significantly in age (repair 37, tenodesis 52), so lower demand may partly explain better tenodesis results. The authors themselves call for a randomized trial and currently reserve repair for patients under 30.
This Level III prospective cohort compared arthroscopic biceps tenodesis against suture anchor repair for isolated type II SLAP lesions. Twenty-five patients were treated by a single surgeon and followed a mean of 35 months. It asks whether tenodesis is a viable alternative to reinsertion, especially in overhead athletes.
When an overhead athlete has an isolated type II SLAP lesion, the reflex answer for years was labral repair. This paper challenged that by showing tenodesis restored sport in ~87% versus ~20% after repair.
The authors offer a mental model for why repair fails. The superior labrum and biceps anchor normally roll medially during abduction and external rotation. A rigid suture anchor repair locks that motion and generates pain during throwing.
The biceps tendon also carries dense sensory-sympathetic innervation, so removing it as a pain generator helps. Strength was preserved after tenodesis, addressing the usual worry about biceps takedown.
Watch the major limitation: the groups differed significantly in age (repair 37, tenodesis 52), so lower demand may partly explain better tenodesis results. The authors themselves call for a randomized trial and currently reserve repair for patients under 30.