Arthroscopic intra-articular vs. subpectoral biceps tenodesis with concomitant rotator cuff repair leads to equivocal MCID achievement

Background

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.

Methods

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 P value threshold of <.05.

Results

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.

Conclusion

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.