title: The influence of suprapectoral arthroscopic biceps tenodesis for isolated biceps lesions on elbow flexion force and clinical outcomes.
abstract: OBJECTIVE
  To prospectively evaluate elbow flexion force, cosmetic and clinical outcome of all-arthroscopic suprapectoral biceps tenodesis for isolated biceps lesions.
  
  
  METHODS
  Tenodesis was performed using a 6.25-mm absorbable interference screw for intraosseous fixation. Seventeen out of 24 patients (70.8 %, median age 49.0 ± 10.1 years; 10 = male) could be included for 24 months follow-up. Elbow flexion strength in 10° and 90° elbow flexion, the upward-directed force of the upper arm in the O'Brien position, objective evaluation of a Popeye-sign deformity and validated clinical scores (CMS, SST, ASES) were assessed preoperatively, 3, 6, 12 and 24 months postoperatively.
  
  
  RESULTS
  Elbow flexion strength in 90° improved significantly from 12 months onwards (P = 0.001) without significant difference to the contralateral arm from 3 months postoperatively (n.s.). At 24 months, an average increase of 46.4 % (median 37.7 %) from preoperative could be seen. The dominant arm was affected in 70.6 %. All scores showed a significant improvement 3 months postoperatively: SST (P = 0.003), ASES (P = 0.006) and total CMS (P < 0.001). Three patients (17.6 %) developed a distalization of the maximum biceps circumference of more than 20 % compared to preoperative.
  
  
  CONCLUSIONS
  All-arthroscopic proximal suprapectoral intraosseous single-limb biceps tenodesis for the treatment of isolated biceps lesions provides good-to-excellent clinical results with significant improvement of elbow flexion strength and clinical scores and no significant difference to the unaffected contralateral arm.
  
  
  METHODS
  IV.
authors.affiliation: Department of Orthopaedics, University Hospital of Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany. mhufeland@gmail.com.
authors.forename: Martin
authors.identifier: http://orcid.org/0000-0002-8941-8571
authors.initials: M
authors.lastname: Hufeland
authors.affiliation: Department of Orthopaedics, University Hospital of Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
authors.forename: Carina
authors.initials: C
authors.lastname: Kolem
authors.affiliation: Department of Orthopaedics, University Hospital of Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Ziskoven
authors.affiliation: Department of Orthopaedics, University Hospital of Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
authors.forename: Jörn
authors.initials: J
authors.lastname: Kircher
authors.affiliation: Department of Orthopaedics, University Hospital of Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Krauspe
authors.affiliation: Department of Orthopaedics, University Hospital of Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
authors.forename: Thilo
authors.initials: T
authors.lastname: Patzer
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D001863:Bone Screws; D004551:Elbow Joint / Q000502:physiology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery*; D020069:Shoulder Pain / Q000209:etiology / Q000601:surgery*; D052256:Tendinopathy / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D053656:Tenodesis / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome
keywords: Biceps pulley; Biceps tenodesis; Elbow flexion force; Interference screw; SLAP; Shoulder