Outcomes And Complications Of Arthroscopic Biceps Tenodesis Vs. Tenotomy In The Management Of Long Head Of Biceps Tendinopathy: A Systematic Review And Meta-Analysis

Abstract

Abstract

Background: Long head of biceps (LHB) tendinopathy is a prevalent condition among individuals with shoulder pain. Surgical management through arthroscopic procedures—namely, biceps tenodesis and tenotomy—has gained prominence. Although both techniques are widely accepted, the choice of procedure remains contentious due to the varied outcomes and complications associated with each. This systematic review and meta-analysis evaluates the comparative effectiveness, complication rates, rehabilitation protocols, and cost-effectiveness of arthroscopic biceps tenodesis and tenotomy for the treatment of LHB tendinopathy.

Methods: A systematic search of several databases, including PubMed, Scopus, and Web of Science, was conducted for studies comparing arthroscopic tenodesis and tenotomy. Outcome measures included patient-reported outcome measures (PROMs), complications, rehabilitation protocols, and cost-effectiveness.

Results: Tenodesis was associated with superior functional outcomes, reduced complication rates (including lower incidence of Popeye deformity and muscle cramping), and more favorable long-term cost-effectiveness compared to tenotomy. However, tenotomy was less invasive, involved shorter operative times, and incurred lower initial costs, which might make it suitable for low-demand patients.

Conclusion: Arthroscopic tenodesis is preferred for patients with high functional demands due to its superior long-term outcomes and lower complication rates. However, tenotomy remains a viable alternative for patients with lower activity levels, offering advantages in terms of cost and simplicity.