The aim of this study is to compare the clinical results and complications of self-locking biceps tenodesis and double 360 lasso loop biceps tenodesis for the treatment of long chief of biceps or superior labrum anterior-posterior (SLAP) tendon pathology during shoulder arthroscopy in patients undergoing arthroscopic rotator cuff repair. Currently, there is no consensus on the use of tenodesis versus tenotomy to treat pathology of the long head of the biceps during arthroscopic rotator cuff repair. Numerous studies have examined the clinical results of long biceps tenotomy versus long biceps tenodesis, and there is no evidence to date of superiority of either technique. At Clinique Générale, we use a new, innovative technique called autobloc tenodesis to treat pathologies of the long head of the biceps. There are no comparative studies between autobloc tenodesis of the biceps and biceps tenodesis. Given its potential advantages, self-locking biceps tenodesis could emerge as the new technique of choice for treating biceps longus tendon pathology, potentially reducing differences in outcomes such as Popeye deformity. The information provided by this study could potentially guide future clinical practice, helping surgeons to choose the most appropriate treatment for their patients suffering from long biceps tendon pathology.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
100
the LHB tendon is detached from its origin in the superior labrum. This technique supports the self-locking mechanism of the LHB tendon in the bicipital groove by detaching the tendon from the Y-shaped superior glenoid, including the superior labrum. A radiographically visible suture will be attached to the proximal part of the LHB tendon to facilitate later localization of the LHB tendon during imaging (3-0 stainless steel, ethicon).
LHB tendon is detached from its origin, and sutured. Next, the LHB tendon is fixed in the bicipital groove using a 360-lasso loop tenodesis technique. A radiographically visible suture will be attached to the proximal part of the LHB tendon to facilitate subsequent localization of the LHB tendon during imaging (3-0 stainless steel, ethicon).
Clinique Générale
Annecy, France
RECRUITINGConstant score (CMS)
The CMS is a 100-point scale comprising four components, including a patient-reported section (pain 15 points and activity level 20 points), for a total of 35 points. Alongside this, there is a doctor-reported section (shoulder strength 25 points, range of motion 40 points) for a total of 65 points.
Time frame: 1 year after surgery
American Shoulder and Elbow Surgeons Score
The ASES is a 100-point scale comprising 2 assessment dimensions: pain and activities of daily living.
Time frame: 6 weeks, 3 months, 6 months, 1 year after surgery
Subjective Shoulder Value (SSV)
The SSV is a single-question assessment of the patient's perceived shoulder function expressed as a percentage of normal.
Time frame: 6 weeks, 3 months, 6 months, 1 year after surgery
LHB score
The LHB score assesses symptoms and function related to long head of the biceps tendon pathology.
Time frame: 6 months, 1 year after surgery
Cosmetic appearance
Cosmetic appearance will be assessed by both the patient and the clinician using standardized photographs.
Time frame: 6 weeks, 3 months, 6 months, 1 year after surgery
VAS pain score
Pain intensity will be assessed using a visual analogue scale (VAS) at rest, during activity, and over the bicipital groove.
Time frame: 6 weeks, 3 months, 6 months, 1 year after surgery
Radiograph
Standardized radiographs will assess postoperative migration of the long head of the biceps tendon using a radio-opaque marker.
Time frame: Direct post-op, 6 weeks, 3 months, 6 months after surgery
MRI or Ultra-sound
MRI or ultrasound will assess the postoperative position of the long head of the biceps tendon at final follow-up.
Time frame: 1 year after surgery
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