title: Biceps tenodesis for long head of the biceps after auto-rupture or failed surgical tenotomy: results in an active population.
abstract: BACKGROUND
  Long head of the biceps (LHB) deformity after surgical tenotomy or auto-rupture may result from attrition or injury. The purpose of this study was to describe the surgical outcomes of biceps tenodesis after failed surgical tenotomy or auto-rupture of the LHB tendon in a population of active patients.
  
  
  METHODS
  During a 5-year period, 11 patients with a mean age of 43.3 years (range, 33-56 years) presented with symptoms of biceps cramping with activity (100%), deformity (100%), or pain (36%) at a mean of 8 months (range, 0.5-22 months) from a tenotomy (6 of 11) or an auto-rupture (5 of 11). All patients underwent a mini-open subpectoral biceps tenodesis with interference screw fixation. Patients were independently evaluated by patient-reported outcome measures (Single Assessment Numeric Evaluation [SANE] and Western Ontario Rotator Cuff Index [WORC]) and a biceps position examination.
  
  
  RESULTS
  Of the 11 patients, 10 (91%) completed the study requirements at a mean of 2.6 years (range, 1.6-4.2 years). A total of 9 of the 10 patients (90%) returned to full activity. The mean preoperative SANE score was 61.1 (standard deviation [SD], 8.8), and the mean preoperative WORC score was 53.2 (SD, 9.2), which improved postoperatively to a SANE score of 84.2 (SD, 7.1) and a WORC score of 86 (SD, 8.2). There were no differences in LHB muscle position relative to the antecubital fossa (3.17 cm preoperatively to 3.25 cm postoperatively; P = .35). Deformity was resolved in all patients; 9 of 10 patients reported full resolution of cramping, and pain was resolved in 8 of 10.
  
  
  CONCLUSIONS
  LHB tenodesis after auto-rupture or surgical tenotomy improved symptoms and allowed predictable return to activity and patient satisfaction. Additional work is necessary to determine the optimal treatment of primary biceps lesions.
authors.affiliation: Sports Medicine Service, Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Shawn G
authors.initials: SG
authors.lastname: Anthony
authors.affiliation: Holy Cross Orthopedic Institute, Holy Cross Hospital, Fort Lauderdale, FL, USA; Sports Medicine Division, Department of Orthopedic Surgery, Naval Medical Center San Diego, San Diego, CA, USA.
authors.forename: Frank
authors.initials: F
authors.lastname: McCormick
authors.affiliation: Sports Medicine Service, Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Gross
authors.affiliation: Sports Medicine Service, Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Petar
authors.initials: P
authors.lastname: Golijanin
authors.affiliation: Sports Medicine Service, Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Sports Medicine Division, Department of Orthopedic Surgery, Naval Medical Center San Diego, San Diego, CA, USA. Electronic address: mtprovencher@partners.org.
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Provencher
mesh_terms: D000328:Adult; D001132:Arm; D001863:Bone Screws; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal; D012086:Reoperation; D012421:Rupture / Q000601:surgery; D013708:Tendon Injuries / Q000601:surgery*; D013710:Tendons / Q000601:surgery*; D053656:Tenodesis; D058971:Tenotomy / Q000009:adverse effects; D017211:Treatment Failure
keywords: Popeye deformity; SLAP; biceps tenotomy; long head of biceps; superior labrum; tenodesis; tenotomy