title: Clinical success of biceps tenodesis with and without release of the transverse humeral ligament.
abstract: BACKGROUND
  Multiple methods for biceps tenodesis exist, but long-term studies have demonstrated high failure rates. We hypothesized that tenodesis techniques that do not release the biceps sheath are associated with a higher surgical revision rate than those that do.
  
  
  METHODS
  A retrospective study was conducted of 127 biceps surgeries over a 2-year period. The mean follow-up post surgery was 22 months (range, 6-59). Clinical failure was defined as ongoing pain localized in the biceps groove, severe enough to warrant revision surgery.
  
  
  RESULTS
  When all techniques that released the biceps sheath (6.8%, 4/59) were compared to those that did not release the biceps sheath (20.6%, 14/68), a statistically significant difference was found, P = .026 (chi-square). Proximal arthroscopic techniques were revised at a significantly higher rate than distal tenodesis techniques (P = .005).
  
  
  CONCLUSIONS
  Biceps tenodesis techniques which do not release the biceps sheath or remove the tendon from the sheath have increased revision rates, compared to techniques that do. This may be supportive evidence for the theory that residual pain generating elements in the biceps groove is a cause of failure of proximal tenodesis methods.
authors.affiliation: Center for Sports Medicine and Orthopaedics, Chattanooga, TN 37404, USA. bsanders@sportmed.com
authors.forename: Brett
authors.initials: B
authors.lastname: Sanders
authors.forename: Kyle P
authors.initials: KP
authors.lastname: Lavery
authors.forename: Scott
authors.initials: S
authors.lastname: Pennington
authors.forename: Jon J P
authors.initials: JJ
authors.lastname: Warner
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D001696:Biomechanical Phenomena; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006811:Humerus; D008022:Ligaments / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology / Q000601:surgery*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery*; D020069:Shoulder Pain / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D013710:Tendons / Q000601:surgery*; D053656:Tenodesis / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult