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Open Compared with Arthroscopic Biceps Tenodesis

A Systematic Review

Hurley, Daire J.1,2; Hurley, Eoghan T., MB, BCh1,3; Pauzenberger, Leo, MD1; Lim Fat, Daren, MCh, FEBOT1; Mullett, Hannan, MCh, FRCSI(Tr&Orth)1

doi: 10.2106/JBJS.RVW.18.00086
Evidence-Based Systematic Reviews

Background: Biceps tenodesis can be performed via an open or arthroscopic approach, and there is currently no consensus over which method is superior. The purpose of this study was to systematically review the cohort studies available in the literature to ascertain if open or arthroscopic techniques for biceps tenodesis result in superior clinical outcomes.

Methods: A systematic search of articles in MEDLINE, Embase, and the Cochrane Library databases was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Cohort studies comparing the open and arthroscopic techniques for biceps tenodesis were included.

Results: Seven clinical trials were identified with 598 patients. The mean follow-up was 23.6 months. In all of the included studies, there was no significant difference (p > 0.05) in any of the functional outcome scoring systems used, including, most commonly, the American Shoulder and Elbow Surgeons (ASES) score and the Constant score. Similarly, no study found a significant difference (p > 0.05) in either patient satisfaction or return to sport. However, 2 studies found a slightly higher rate of complications with the arthroscopic technique due to an increased rate of fixation failure in 1 study and stiffness in the other study.

Conclusions: This study found that both open tenodesis and arthroscopic tenodesis result in excellent clinical outcomes, with no significant differences between either method.

Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

1Sports Surgery Clinic, Dublin, Ireland

2University College Dublin, Dublin, Ireland

3Royal College of Surgeons in Ireland, Dublin, Ireland

E-mail address for E.T. Hurley:

Investigation performed at the Sports Surgery Clinic, Dublin, Ireland

Disclosure: There was no source of external funding for this study. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (

Copyright © 2019 by The Journal of Bone and Joint Surgery, Incorporated
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