Poster 143: Variation in Postoperative Tendon Migration Does Not Result in Significant Differences in Patient Reported Outcomes in Patients Undergoing Arthroscopic or Open Biceps Tenodesis Using All-Suture Suture Anchor and Interference Screw

Abstract

Objectives:

It is unknown whether the degree of biceps tendon migration influences patient outcomes following biceps tenodesis (BT). We aimed to assess the relationship between in vivo tendon migration and patient reported outcomes (PROs) following arthroscopic and open BT using suture anchor (SA) and interference screw (IS) constructs.

Methods:

One hundred twenty patients undergoing arthroscopic and open BT with SA or IS fixation at a single academic center were prospectively enrolled. Postoperative biceps tendon migration was measured via RSA, using a tantalum bead as a radio-opaque marker for tendon migration, with radiographs at 3- and 12-weeks postoperatively. PROs (Constant, SANE and PROMIS) were collected preoperatively, and at 6 months, 1 year, and 2 years. A Bonferroni correction was made for multiple comparisons.

Results:

Preoperative PRO completion was as follows: 20 (16.7%) ASES, 64 (53.3%) Constant, 96 (80.0%) SANE, and 108 (90.0%) PROMIS-UE. Patients with an open SA had a younger median age (48.4, IQR 38-55.4, P=0.014) and fewer dominant-sided surgeries (8/33 patients or 24.2%, P=0.003). PRO scores did not differ by groups for any questionnaire at all timepoints. There were no significant differences in likelihood of achieving MCID for ASES (P>0.99), Constant (P=0.87), SANE (P=0.68), or PROMIS-UE (P>0.99) between groups. In univariable analysis, no patient- or surgery-related factors served as significant predictors of achieving MCID at 6 months. Notably, neither RSA bead migration>3cm (Constant: OR= -0.54, 95%CI -2.53-1.45, P=0.60; SANE: collinear; PROMIS-UE: collinear) nor Popeye deformities (Collinear for all PROs) were negatively associated with likelihood of achieving MCID.

Conclusions:

Patient-reported outcomes are similar for patients undergoing arthroscopic BT via IS and SA, and open BT via IS and SA. No significant predictors of achieving MCID at 6 months were identified, including migration of the RSA bead. Biceps tendon migration was not significantly correlated with patient reported outcomes.

Table 1.

Demographics and PROs in Patients with biceps tenodesis

Figure 1.

Scatter plot of 6-Month change in Constant and Tantalum bead migration (R⁁2=0.03,P=0.38)

Figure 2.

Scatter plot of 6-Month change in SANE and Tantalum bead migration (R⁁2 = 0.004, P=0.78)

Figure 3.

Scatter plot of 6-Month change in PROMIS UE and Tantalum bead migration (R⁁2 = 0.01, P=0.42)