The modified Norwegian method of biceps tenodesis: how well does it work?

PURPOSE: The purpose of this study was to evaluate clinical outcomes and complications in a series of patients who underwent the modified Norwegian method (MNM) of biceps tenodesis by a single shoulder surgeon.

METHODS: A retrospective review of charts from all patients who underwent the modified Norwegian method of biceps tenodesis by the senior author during a 5-year period between 2008 and 2013 was performed. After all patients were identified, informed consent was obtained and DASH and ASES surveys were administered. Inclusion criteria for the study were a minimum 2-year follow-up after MNM tenodesis and appropriate adherence to DASH and ASES survey protocol. Data obtained included: demographic data, time to follow-up, hand dominance, concomitant procedures, workman's compensation (WC) status, DASH and ASES surveys, and complications. A complication was defined as rupture of the tenodesis or post-operative infection. Residual shoulder pain was considered as treatment failure. The data were then analysed using statistical software. In this time period, 94 biceps tenodeses using the MNM technique were performed. Follow-up rate was 75/94 patients (80 %). Of 75 patients, 15 (20 %) had an isolated tenodesis performed.

RESULTS: There was no statistically significant difference in DASH or ASES scores when comparing isolated tenodesis patients to those who had concomitant procedures. WC patients had worse DASH and ASES scores (p = 0.016; p = 0.002). The complication rate was 2/75 (3 %), which were both ruptured tenodeses. Of 75 patients, 3 (4 %) experienced treatment failure with residual anterior shoulder pain.

CONCLUSIONS: There is debate in the literature regarding the optimal method of biceps tenodesis. This paper demonstrates that the MNM tenodesis appears to be a simple, efficient, and effective alternative to other methods of biceps tenodesis with subjective outcome scores and complication rates that parallel other methods previously described in the literature.

LEVEL OF EVIDENCE: IV.