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Biceps tendon transfer shows efficacy for treating biceps pathology in active patients
Three of 25 patients had early traumatic failures, which were related to noncompliance with postoperative rehabilitation.
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Performing arthroscopic subdeltoid transfer of the long head of the biceps tendon appears safe and reliable for treating chronic, refractory biceps pathology in active patients, according to a study by investigators in New York.
"It appears that this procedure yields equivalent results to tenotomy for pain relief, better results than tenotomy for fatigue discomfort, and equivalent results compared to other methods of tenodesis," the authors reported in the study.
Mark C. Drakos, MD, and colleagues evaluated the clinical and functional outcomes for 40 shoulders of 39 patients treated with long head of the biceps tendon (LHBT) transfer. Patients averaged 38.5 years of age. All cases had been diagnosed with either biceps pathology or instability.
Surgeons performed either arthroscopic-assisted or fully arthroscopic transfers alone or combined with another shoulder procedure.
At 28 months mean follow-up, the American Society of Shoulder and Elbow Surgeons (ASES) score averaged 78.72 points, the L'Insalata Shoulder Rating Questionnaire score averaged 75.57 points and the University of California at Los Angeles (UCLA) shoulder evaluation test score averaged 27.32 points, according to the study.
In a subset of 25 patients who underwent an isolated LHBT transfer, the L'Insalata score averaged 85.2 points, the UCLA score averaged 29.5 points and the ASES score averaged 84.8 points, the authors noted.
"Three patients had early traumatic failure related to noncompliance with postoperative rehabilitation protocol. This included the only two patients who had a Popeye sign at follow-up during active elbow flexion," the authors wrote.
Investigators found no statistically significant differences in side-to-side strength using a 10-pound weight. Also, 80% of patients self-rated their outcomes as good to excellent, and 20% self-graded as fair or poor, including the three early failures, the authors reported.
"All of the patients reported no arm pain at rest with regard to the biceps. Ninety-five percent of patients reported no biceps tenderness upon palpation of the bicipital groove," they wrote.
Only five patients complained of fatigue discomfort, which was isolated to the biceps muscle following resisted elbow flexion, according to the study, published in Arthroscopy.
For more information:
- Drakos MC, Verma NN, Gulotta LV, et al. Arthroscop ic transfer of the long head of the biceps tendon: Functional outcome and clinical results. Arthroscopy. 2008;24:217-223.