Management of proximal biceps tendon pathology

Table 1 Comparison of biceps tenotomy versus biceps tenodesis

	Biceps tenotomy	Biceps tenodesis
Timing and cost	Quicker, shorter procedure with a lower cost	Technically more challenging with a longer surgical and rehabilitation time as well as a higher cost
Patient population	Symptomatic patients with biceps tenosynovitis > 60 yr of age, individuals with lower demand occupations, those with minimal cosmesis concerns	Symptomatic athletic patients, individuals with higher demand occupations, those with cosmesis concerns
Complications	Postoperative Popeye deformity, muscle belly cramping, discomfort and fatigue	Risk of infection, loss of fixation and recurrence of Popeye deformity, implant failure

Table 2 Comparison of open biceps tenodesis versus arthroscopic biceps tenodesis

	Open approach	Arthroscopic approach
Timing and cost	Lower cost with slightly longer operation time	Higher cost with slightly lower operation time
Functional outcomes	No significant difference found between ASES, Constant, UCLA, DASH, or SST scores
Range of motion	Similar in both approaches, forward range of motion slightly higher in arthroscopic approach
Complications	Higher overall rate of complications such as wound healing issues, hematoma/seroma formation, nerve injury, deep vein thrombosis, and general anesthetic complications	Lower overall rate of complications, but higher incidence of postoperative stiffness and bicipital groove tenderness in early stages of recovery

ASES: American shoulder and elbow surgeons; DASH: Disabilities of the arm, shoulder and hand; SST: Simple shoulder test.