Functional symptomatology following Biceps Tenodesis compared to Biceps Tenotomy or Rupture

Authors: Koenig et al.

References: ICSS, Washington, 2004

Abstract
The purpose of this study was to identify the occurrence of biceps muscle cramping, pain, or deformity following biceps tenodesis and compared to biceps tenotomy of rupture. Sixty-one patients who were treated for biceps disorders between 1999 and 2001 were reviewed. Thirty-seven (mean age 48) had undergone a tenodesis and 24 (mean age 60) had either a tenotomy or spontaneous rupture. Follow-up was 12-48 months. Evaluation was by history, physical, and ASES Score.  Mean ASES index, pain, and ADL scores were 74/2.5/21 after tenodesis, 72/2/20 after tenotomy, and 68/2.7/17 after rupture (differences NS). 53% of tenodesis patients had local tenderness to direct pressure in the groove, but none had muscle symptoms otherwise. 68% of tenotomy and rupture patients did not like the deformity and 72% had pain and cramping in the biceps muscle with activities requiring resisted supination and flexion of the elbow.  We conclude that although tenotomy is technically easier it should be reserved for low demand or sedentary patients and that tenodesis is preferable in active patients.