While both biceps tenodesis and SLAP repair result in good functional outcomes for patients, biceps tenodesis has a higher return to preinjury sports level and lower reoperation rates, according to a new study.
Biceps Tenodesis or SLAP Repair? Answer May Surprise You
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Secondary#bicepstenodesis#slaprepair#superiorlabralanteriorposteriortears
“The ideal treatment algorithm is still controversial for Superior Labral Anterior-Posterior (SLAP) tears. In this systematic review, we aimed to clarify and ascertain which treatment modality is effective and more usable in which conditions,” the researchers of “Repair versus biceps tenodesis for the slap tears: A systematic review,” wrote. The study was published online on April 22, 2021 in the Journal of Orthopaedic Surgery.
The researchers conducted a systematic review from the inception of the procedures to September 30, 2020. Six studies and a total of 287 patients were used in the final analysis.
A comparison between the two techniques was made based on demographics, patient satisfaction, functional outcomes, return to preinjury sports level, reoperation, stiffness, sling time and rehabilitation protocols.
Overall, there were 160 SLAP repair and 127 biceps tenodesis performed. In four of the studies, biceps tenodesis was considered the more satisfied technique, but the results between the two groups was not statistically significant.
However, the percentage of return to sport and preinjury level was higher in biceps tenodesis in five of the studies. The total reoperation rate for SLAP repair was 19/160 (12%) and biceps tenodesis was 7/127 (6%).
“The biceps tenodesis has a higher return to preinjury sports level higher patient satisfaction and lower reoperation rates, but functional scores are similar between SLAP repair in patients with SLAP tear,” the researchers concluded.
“Stiffness and reoperation are the specific complications after treatment of SLAP tears. Stiffness was reported in three of the included studies and the rate was always higher in the SLAP repair group. Reoperation rate changed between 0% and 40% in the SLAP repair groups of the included studies and always equal or higher from the biceps tenodesis group except one study.”
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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