Conversion of Failed Proximal Long Head of the Biceps Tenodesis to Distal Subpectoral Tenodesis: Outcomes in an Active Population

Abstract Purpose To assess failure rates and patient reported outcomes following revision of failed proximal LHB tenodesis. Methods and Materials Patients from an active military population who underwent revision proximal (suprapectoral) to distal (subpectoral) long head of the biceps (LHB) tenodesis were prospectively enrolled. Patients were included if they were between the ages of 16-60 years presenting after a prior biceps tenodesis with mechanical failure and clinical failure, defined as Single Assessment Numeric Evaluation (SANE) or American Shoulder and Elbow Surgeons (ASES) Results From 2004 to 2010, a total of 12 patients (all male) with a mean age of 39.9 years (range, 30-54) were assessed at a mean follow-up time of 29 months (range, 24-38). Nine patients presented with a failed tenodesis construct located at the top of the bicipital groove and nine patients had LHB tendons originally affixed with an interference screw. Diagnostic arthroscopy revealed that the majority of patients (10/12) had excessive scarring at the site of prior fixation. Mean preoperative assessments of SANE (70.4) and ASES (59.9) improved postoperatively to SANE (90.3; p-value Conclusion Patients presenting with symptoms following a proximal LHB tenodesis can be successfully converted to a distal (subpectoral) LHB tenodesis with favorable outcomes. Although in a small sample, there was excessive scarring and synovitis in a majority which improved significantly when treated with a revision subpectoral tenodesis with minimal complication risk and no reported failures.