Restoring the anatomic tension relationship of the long head of the biceps during tenodesis: A prospective, randomized controlled trial

This RCT of 160 patients undergoing biceps tenodesis (mostly with concomitant rotator cuff or other shoulder procedures) compared a standard landmark-based tensioning technique to a patient-specific anatomic tensioning technique. At final follow-up (mean 19.6 months), ASES scores, VAS pain, forward flexion, and external rotation were statistically similar between groups (p=0.604, 0.308, 0.171, 0.726 respectively), though the intervention group had significantly higher ASES scores at 6 weeks (mean difference 9.1, 95% CI 0.1-18.0, p=.048) and, oddly, significantly lower ASES scores at 12 months (mean difference -16.8, 95% CI -33.1 to -0.5, p=.044).

AI summary · from the full text · reviewed by Pukhraj Gaheer, Medical Student, Queen's University before publishing

Why it mattersBiceps tenodesis is common and lacks a standardized tensioning technique, so evidence on whether a more meticulous patient-specific method actually improves outcomes helps surgeons decide if the extra technical effort is worthwhile.

Presenting this at rounds? Start here

• ?The primary outcome (ASES at final follow-up) was not significant, yet a significant result appeared at 6 weeks and an unexplained significant worse result appeared at 12 months among six time points tested without correction for multiplicity: how much of this is chance given multiple comparisons?
• ?If you perform tenodesis routinely, does a possible early (6-week) functional advantage with patient-specific tensioning change your technique, given no advantage was seen at 3, 6, or 12 months, or at final follow-up?