Biceps tenodesis, transfer high return to play rates among young athletes
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Biceps tenodesis and transfer may provide effective surgical treatment for a younger athletic population with biceps labral complex injuries, with high return to play rates and outcome scores, according to published results.
Researchers collected questionnaires on patient-reported shoulder-specific outcome measure scores, level of postoperative play and other relevant information among 41 patients mean age 21.3 years who underwent biceps tenodesis and transfer procedures with a minimum follow-up of 24 months.
Results showed patients had a mean Kerlan-Jobe Orthopaedic Clinic score of 71.7, DASH-Sports score of 21.3, Single Assessment Numeric Evaluation score of 79.4 and Numeric Rating Scale pain score of 1.8. Patients who underwent biceps transfer had statistically better scores for all patient-reported outcome measures vs. biceps tenodesis, according to results. Researchers found 63% of patients played a primary overhead throwing sport. Researchers also noted 95% of patients returned to play, of whom 67% returned to their preoperative level or higher.
“The high return to play rate in these patients suggests that biceps relocation procedures such as tenodesis and transfer may have successful functional outcomes, even in younger athletes,” they wrote.
Perspective
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Michael Q. Freehill, MD, FAAOS
Return to overhead sports following a superior labrum anterior and posterior (SLAP) repair is a known challenge. Systematic reviews of arthroscopic SLAP repairs have generally yielded poor return to play statistics, particularly when the overhead athlete cohorts are examined. Prior studies have yielded a return to play at the same level of approximately 63% in the overhead athlete.
This retrospective review by Lin and colleagues provides evidence that a biceps tenodesis or transfer could provide another avenue for return to play in the face of isolated biceps-labral complex injuries. The current study surveyed athletes following their respective surgeries, reporting 65% of overhead athletes returning to their preoperative level of play. As a subset within this cohort, all baseball players returned to play with 80% at preoperative level or above, substantially higher than traditional SLAP repairs.
Ultimately, while tenodesis/transfer may provide a potentially more durable and improved option for biceps-labral complex injuries, return to play in the overhead athlete remains inconsistent likely due to concomitant pathologies and soft tissue imbalances that often exist in this particular class of athletes. The biceps tenodesis/transfer procedure could provide the foundation for a prospective study compared with nonoperative treatment of similar injuries, in which prior studies have revealed return to play rates in overhead athletes ranging 66% to 74%.
References:
Abdul-Rassoul H, et al. Orthop J Sports Med. 2019;doi:10.1177/2325967119841892.
Edwards SL, et al. Am J Sports Med. 2010;doi:10.1177/0363546510370937.
Gorantla K, et al. Arthroscopy. 2010;doi:10.1016/j.arthro.2009.08.017.
Park J, et al. Clinics in Shoulder and Elbow. 2017;doi:10.5397/cise.2017.20.2.77.
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