Effectiveness of Biceps Tendon Tenotomy and Fixation versus Biceps Tendon Repair through Arthroscopy for Shoulder Superior Labrum Anterior Posterior Lesions: A Meta-analysis_West China Medical Journal

Authors：

 YANGChen ¹ , ZHAOChen ² , TANGJun ³ , GEXin-jiang ¹ ,  BIQing ²

1. Department of Orthopedics, the First People's Hospital of Akesu, Akesu, Xinjiang 843000, P. R. China;
2. Department of Orthopedics, the People's Hospital of Zhejiang Province, Hangzhou, Zhejiang 310014, P. R. China;
3. Department of Orthopedics, the People's Hospital of Wuyi, Wuyi, Zhejiang 321200, P. R. China;

Corresponding author：

BIQing, Email: yangchen.doctor@gmail.com

Keywords：

Biceps tenotomy and fixation; Biceps tendon repair; Superior labrum anterior posterior lesions; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1002-0179.20150125

Video：

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Objective To evaluate the clinical therapeutic effect of biceps tendon tenotomy and fixation versus biceps tendon repair for shoulder superior labrum anterior posterior (SLAP) lesions with Meta-analysis. Methods The databases such as PubMed, EMbase, the Cochrane Library (Issue 3, 2014), CBM, VIP and CJFD (from the establishment time of databases to December 2014) were searched to collect all randomized controlled trials (RCT) on the clinical effectiveness of biceps tendon tenotomy and fixation versus biceps tendon repair for shoulder SLAP lesions. Two reviewers independently screened the literature according to the inclusive and exclusive criteria, extracted the data, and assessed the methodological quality of included studies. After the data extraction and methodological quality evaluation, meta-analysis was conducted with RevMan 5.0 software. Results Three RCT were included. Among the total 137 patients involved, Meta-analysis showed that, compared with the biceps tendon repair group, the biceps tenotomy group had superior amount in the UCLA score [WMD=3.43, 95%CI (2.29, 4.56), P<0.000 01], the shoulder pain [WMD=1.18, 95%CI (0.30, 2.05), P=0.009], function [WMD=0.96, 95%CI (0.51, 1.41), P<0.000 1] and satisfaction [WMD=1.16, 95%CI (0.31, 2.01), P=0.007] with significant differences. But there were no significant differences between the two groups in the shoulder flextion [WMD=0.10, 95%CI (-0.87, 1.06), P=0.84] and strength [WMD=0.13, 95%CI (-0.09, 0.35), P=0.25]. Conclusion Based on the current studies, the biceps tenotomy and fixation is superior to the biceps tendon repair in treating shoulder SLAP lesions. For the quality restrictions and possible publication bias of the included studies, more double blind, high quality RCT are required to further evaluate the effects.

Citation： YANGChen, ZHAOChen, TANGJun, GEXin-jiang, BIQing. Effectiveness of Biceps Tendon Tenotomy and Fixation versus Biceps Tendon Repair through Arthroscopy for Shoulder Superior Labrum Anterior Posterior Lesions: A Meta-analysis. West China Medical Journal, 2015, 30(3): 426-431. doi: 10.7507/1002-0179.20150125 Copy

1.	Skare Ø, Liavaag S, Reikerås O, et al. Evaluation of Oxford instability shoulder score, Western Ontario shoulder instability index and Euroqol in patients with SLAP (superior labral anterior posterior) lesions or recurrent anterior dislocations of the shoulder[J]. BMC Res Notes, 2013, 15(6):621-627.
2.	Osti L, Soldati F, Cheli A, et al. Biceps instability and SLAP type Ⅱ tear in overhead athletes[J]. Muscles Ligaments Tendons J, 2013, 21(4):258-266.
3.	吴泰相, 刘关键. 隐蔽分组(分配隐藏)和盲法的概念、实施与报告[J]. 中国循证医学杂志, 2007, 7(3):222-225.
4.	Abbot AE, Li X, Busconi BD. Arthroscopic treatment of concomitant superior labral anterior posterior (SLAP) lesions and rotator cuff tears in patients over the age of 45 years[J]. Am J Sports Med, 2009, 37(10):1358-1362.
5.	Franceschi F, Longo UG, Ruzzini LA, et al. No advantages in repairing a type Ⅱ superior labrum anterior and posterior (SLAP) lesion when associated with rotator cuff repair in patients over age 50[J]. Am J Sports Med, 2008, 36(2):247-253.
6.	Kim SJ, Lee IS, Kim SH, et al. Arthroscopic repair of concomitant type Ⅱ SLAP lesions in large to massive rotator cuff tears comparison with biceps tenotomy[J]. Am J Sports Med, 2012, 40(12):2786-2793.
7.	Guyatt GH, Oxman AD, Montori V, et al. GRADE guidelines:5. Rating the quality of evidence:publication bias[J]. J Clin Epidemiol, 2011, 64(12):1277-1282.
8.	Park MJ, Hsu JE, Harper C, et al. Poly-L/D-lactic acid anchors are associated with reoperation and failure of SLAP repairs[J]. Arthroscopy, 2011, 27(5):1335-1340.
9.	Kanatli U, Ozturk BY, Bolukbasi S. Arthroscopic repair of type Ⅱ superior labrum anterior posterior (SLAP) lesions in patients over the age of 45 years:a prospective study[J]. Arch Orthop Trauma Surg, 2011, 131(8):1107-1113.
10.	Alpert JM, Wuerz TH, O'donnell TF, et al. The effect of age on the outcomes of arthroscopic repair of type Ⅱ superior labral anterior and posterior lesions[J]. Am J Sports Med, 2010, 38(11):2299-2303.
11.	Hsu AR, Ghodadra NS, Provencher MT, et al. Biceps tenotomy versus tenodesis:a review of clinical outcomes and biomechanical results[J]. J Shoulder Elbow Surg, 2011, 20(2):326-332.
12.	Guyatt GH, Oxman AD, Vist G, et al. GRADE guidelines:4. Rating the quality of evidence:study limitations (risk of bias)[J]. J Clin Epidemiol, 2011, 64(4):407-415.
13.	吴泰相, 刘关键, 李静. 影响系统评价质量的主要因素浅析[J]. 中国循证医学杂志, 2005, 5(1):51-58.
14.	Franceschi F, Longo UG, Ruzzini L, et al. No advantages in repairing a type Ⅱ superior labrum anterior and posterior (SLAP) lesion when associated with rotator cuff repair in patients over age 50:a randomized controlled trial[J]. Am J Sports Med, 2008, 36(2):247-253.

1. Skare Ø, Liavaag S, Reikerås O, et al. Evaluation of Oxford instability shoulder score, Western Ontario shoulder instability index and Euroqol in patients with SLAP (superior labral anterior posterior) lesions or recurrent anterior dislocations of the shoulder[J]. BMC Res Notes, 2013, 15(6):621-627.
2. Osti L, Soldati F, Cheli A, et al. Biceps instability and SLAP type Ⅱ tear in overhead athletes[J]. Muscles Ligaments Tendons J, 2013, 21(4):258-266.
3. 吴泰相, 刘关键. 隐蔽分组(分配隐藏)和盲法的概念、实施与报告[J]. 中国循证医学杂志, 2007, 7(3):222-225.
4. Abbot AE, Li X, Busconi BD. Arthroscopic treatment of concomitant superior labral anterior posterior (SLAP) lesions and rotator cuff tears in patients over the age of 45 years[J]. Am J Sports Med, 2009, 37(10):1358-1362.
5. Franceschi F, Longo UG, Ruzzini LA, et al. No advantages in repairing a type Ⅱ superior labrum anterior and posterior (SLAP) lesion when associated with rotator cuff repair in patients over age 50[J]. Am J Sports Med, 2008, 36(2):247-253.
6. Kim SJ, Lee IS, Kim SH, et al. Arthroscopic repair of concomitant type Ⅱ SLAP lesions in large to massive rotator cuff tears comparison with biceps tenotomy[J]. Am J Sports Med, 2012, 40(12):2786-2793.
7. Guyatt GH, Oxman AD, Montori V, et al. GRADE guidelines:5. Rating the quality of evidence:publication bias[J]. J Clin Epidemiol, 2011, 64(12):1277-1282.
8. Park MJ, Hsu JE, Harper C, et al. Poly-L/D-lactic acid anchors are associated with reoperation and failure of SLAP repairs[J]. Arthroscopy, 2011, 27(5):1335-1340.
9. Kanatli U, Ozturk BY, Bolukbasi S. Arthroscopic repair of type Ⅱ superior labrum anterior posterior (SLAP) lesions in patients over the age of 45 years:a prospective study[J]. Arch Orthop Trauma Surg, 2011, 131(8):1107-1113.
10. Alpert JM, Wuerz TH, O'donnell TF, et al. The effect of age on the outcomes of arthroscopic repair of type Ⅱ superior labral anterior and posterior lesions[J]. Am J Sports Med, 2010, 38(11):2299-2303.
11. Hsu AR, Ghodadra NS, Provencher MT, et al. Biceps tenotomy versus tenodesis:a review of clinical outcomes and biomechanical results[J]. J Shoulder Elbow Surg, 2011, 20(2):326-332.
12. Guyatt GH, Oxman AD, Vist G, et al. GRADE guidelines:4. Rating the quality of evidence:study limitations (risk of bias)[J]. J Clin Epidemiol, 2011, 64(4):407-415.
13. 吴泰相, 刘关键, 李静. 影响系统评价质量的主要因素浅析[J]. 中国循证医学杂志, 2005, 5(1):51-58.
14. Franceschi F, Longo UG, Ruzzini L, et al. No advantages in repairing a type Ⅱ superior labrum anterior and posterior (SLAP) lesion when associated with rotator cuff repair in patients over age 50:a randomized controlled trial[J]. Am J Sports Med, 2008, 36(2):247-253.

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West China Medical Journal

Effectiveness of Biceps Tendon Tenotomy and Fixation versus Biceps Tendon Repair through Arthroscopy for Shoulder Superior Labrum Anterior Posterior Lesions: A Meta-analysis

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