Greif Dylan N, Shaikh Hashim J F, Anderson Devon E, Bronstein Robert, Nicandri Gregg T, Giordano Brian D, Voloshin Ilya, Maloney Michael D, Mannava Sandeep
Department of Orthopaedics & Physical Performance, University of Rochester Medical Center, Rochester, NY, USA.
Department of Orthopaedic Surgery, Duke University, Durham, NC, USA.
JSES Int. 2025 Feb 14;9(3):728-734. doi: 10.1016/j.jseint.2025.01.020. eCollection 2025 May.
Pathologies involving the long head of the biceps brachii tendon often accompany rotator cuff tears, contributing to increased physical pain. Disagreement exists in the literature regarding the outcomes of open subpectoral vs. arthroscopic biceps tenodesis during concomitant arthroscopic rotator cuff repair (ARCR), with limited studies assessing Patient-Reported Outcomes Measurement Information System (PROMIS) in this context. This study aims to evaluate a cohort undergoing open subpectoral vs. arthroscopic intra-articular biceps tenodesis with concomitant ARCR, examining differences in PROMIS outcomes and the ability to achieve a minimal clinically important difference (MCID). We hypothesize there is not a significant difference in attaining MCID for PROMIS outcomes between open subpectoral and arthroscopic intra-articular biceps tenodesis during ARCR.
A retrospective analysis was conducted on patients undergoing ARCR with concurrent biceps tenodesis. Patient-reported outcomes, including PROMIS Depression, Pain Interference, and Physical Function scores, were retrospectively reviewed. The patient cohort was stratified into two groups based on the type of biceps tenodesis performed. MCID was defined as half the standard deviation of the average preoperative scores for each cohort. Regression analysis was performed to control for the influence of confounding variables. Statistical significance was determined at a value threshold of <.05.
A total of 197 patients were included for final data analysis. 100 patients underwent arthroscopic biceps tenodesis and 97 patients who underwent open biceps tenodesis, with average follow-up 2.39 vs. 2.21 years, respectively. Bivariate analysis showed no significant differences between subpectoral and arthroscopic cohorts in demographic or clinical variables. Both groups exhibited significant improvement at the final follow-up in all three PROMIS domains without statistically significant intergroup differences. Multivariate analysis identified racial and insurance disparities in preoperative scores but not in postoperative outcomes. Logistic regression indicated PROMIS domains and anchor usage predicted MCID, with no significant difference based on biceps tenodesis type.
This study suggests that open subpectoral vs. arthroscopic intra-articular biceps tenodesis during concomitant ARCR does not significantly impact PROMIS outcomes or the likelihood of achieving MCID.
肱二头肌长头肌腱相关病变常伴随肩袖撕裂，导致身体疼痛加剧。关于在关节镜下肩袖修复术（ARCR）同期进行胸小肌下开放性与关节镜下肱二头肌固定术的疗效，文献中存在分歧，在此背景下评估患者报告结局测量信息系统（PROMIS）的研究有限。本研究旨在评估一组接受胸小肌下开放性与关节镜下关节内肱二头肌固定术并同期进行ARCR的患者，检查PROMIS结局的差异以及达到最小临床重要差异（MCID）的能力。我们假设在ARCR期间，胸小肌下开放性与关节镜下关节内肱二头肌固定术在实现PROMIS结局的MCID方面没有显著差异。
对接受ARCR并同期进行肱二头肌固定术的患者进行回顾性分析。回顾性审查患者报告的结局，包括PROMIS抑郁、疼痛干扰和身体功能评分。根据所进行的肱二头肌固定术类型将患者队列分为两组。MCID定义为每个队列术前平均评分标准差的一半。进行回归分析以控制混杂变量的影响。在<0.05的 值阈值下确定统计学显著性。
共有197例患者纳入最终数据分析。100例患者接受了关节镜下肱二头肌固定术，97例患者接受了开放性肱二头肌固定术，平均随访时间分别为2.39年和2.21年。双变量分析显示，胸小肌下组与关节镜组在人口统计学或临床变量方面无显著差异。两组在所有三个PROMIS领域的最终随访时均表现出显著改善，组间差异无统计学意义。多变量分析确定了术前评分中的种族和保险差异，但术后结局无差异。逻辑回归表明，PROMIS领域和锚定使用可预测MCID，基于肱二头肌固定术类型无显著差异。
本研究表明，在同期ARCR期间，胸小肌下开放性与关节镜下关节内肱二头肌固定术对PROMIS结局或实现MCID的可能性没有显著影响。
