TY - JOUR
T1 - Long head BIceps TEnodesis or tenotomy in arthroscopic rotator cuff repair
T2 - BITE study protocol
AU - van Deurzen, Derek Friedrich Petrus
AU - Scholtes, Vanessa Antoinet Bernice
AU - Willigenburg, Nienke Willemien
AU - Gurnani, Navin
AU - Verweij, Lukas Pieter Eduard
AU - van den Bekerom, Michel Pieter Jozef
AU - Raven, Erik E.J.
AU - Zijl, Jacco A.C.
AU - Auw Yang, Kiem G.
AU - Wessel, Ronald N.
AU - Wolterbeek, Nienke
AU - van den Borne, Maaike P.J.
AU - Koenraadt, Koen L.M.
AU - Onstenk, Ron
AU - van Beers, Loes W.A.H.
AU - Krijnen, M.
AU - de Meijier, Hans E.
AU - Engelsma, Yde
AU - Heneweer, Arne
AU - Beimers, Lijkele
AU - Cheung, John
AU - Sierevelt, Inger
AU - Willems, W. J.
AU - Hoelen, Max
AU - Mathijssen, Nina M.
AU - van Noort, Arthur
AU - Alta, Tjarco D.W.
AU - Verhart, Jeanette
AU - Jenner, Jacco M.G.T.
AU - BITE collaboration group
PY - 2016/8/30
Y1 - 2016/8/30
N2 - Background: Optimal treatment of the diseased long head of the biceps (LHB) tendon during rotator cuff repair remains a topic of debate: tenotomy or tenodesis. A recent meta analysis revealed no difference in strength or functional outcome between treatments. The included studies varied in methodological quality, and only two were randomized controlled trials (RCTs). As strong evidence in favor of either tenotomy or tenodesis is still lacking, we designed this randomized controlled trial to compare functional outcomes after tenotomy and tenodesis when performed in adjunct to arthroscopic rotator cuff repair. Methods: Patients older than 50 years with a supraspinatus and/or infraspinatus tendon rupture sized smaller than 3 cm, who are encountered with LHB pathology, will be randomized to either LHB tenotomy or LHB tenodesis. Clinical and patient-reported data will be collected pre-operatively, 6 weeks, 3 months and 1 year after surgery. Primary outcome is overall shoulder function evaluated with the Constant score at 1 year after surgery. As additional measures of shoulder function, two patient reported outcomes (the Dutch Oxford Shoulder Test and the Disabilities of the Arm Shoulder and Hand questionnaire) will be assessed. Other evaluations include cosmetic appearance evaluated by the "Popeye" deformity, elbow flexion strength, arm cramping pain, MRI-based location of the biceps tendon, quality of life, and duration of surgery. To detect non-inferiority with a one-sided, two-sample t-test with 80 % power and a significance level (alpha) of 0.025, the required sample size is 98 patients. Discussion: Treatment of LHB tendon lesions is performed differently around the world and meta analyses do not provide conclusive evidence in favor of one of these treatments. This study will strengthen evidence on the risks and benefits of LHB tenotomy and tenodesis in adjunct to a rotator cuff repair, which is important for managing patient expectations. Trial registration: Dutch Trial Register (NTR3255) January 12, 2012, ClinicalTrials.gov (ID NCT02655848) January 14, 2016, retrospectively registered.
AB - Background: Optimal treatment of the diseased long head of the biceps (LHB) tendon during rotator cuff repair remains a topic of debate: tenotomy or tenodesis. A recent meta analysis revealed no difference in strength or functional outcome between treatments. The included studies varied in methodological quality, and only two were randomized controlled trials (RCTs). As strong evidence in favor of either tenotomy or tenodesis is still lacking, we designed this randomized controlled trial to compare functional outcomes after tenotomy and tenodesis when performed in adjunct to arthroscopic rotator cuff repair. Methods: Patients older than 50 years with a supraspinatus and/or infraspinatus tendon rupture sized smaller than 3 cm, who are encountered with LHB pathology, will be randomized to either LHB tenotomy or LHB tenodesis. Clinical and patient-reported data will be collected pre-operatively, 6 weeks, 3 months and 1 year after surgery. Primary outcome is overall shoulder function evaluated with the Constant score at 1 year after surgery. As additional measures of shoulder function, two patient reported outcomes (the Dutch Oxford Shoulder Test and the Disabilities of the Arm Shoulder and Hand questionnaire) will be assessed. Other evaluations include cosmetic appearance evaluated by the "Popeye" deformity, elbow flexion strength, arm cramping pain, MRI-based location of the biceps tendon, quality of life, and duration of surgery. To detect non-inferiority with a one-sided, two-sample t-test with 80 % power and a significance level (alpha) of 0.025, the required sample size is 98 patients. Discussion: Treatment of LHB tendon lesions is performed differently around the world and meta analyses do not provide conclusive evidence in favor of one of these treatments. This study will strengthen evidence on the risks and benefits of LHB tenotomy and tenodesis in adjunct to a rotator cuff repair, which is important for managing patient expectations. Trial registration: Dutch Trial Register (NTR3255) January 12, 2012, ClinicalTrials.gov (ID NCT02655848) January 14, 2016, retrospectively registered.
KW - Arthroscopy
KW - Functional result
KW - Long head biceps tendon
KW - Randomised controlled trial
KW - Rotator cuff
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UR - http://www.scopus.com/inward/citedby.url?scp=84984858079&partnerID=8YFLogxK
U2 - 10.1186/s12891-016-1230-5
DO - 10.1186/s12891-016-1230-5
M3 - Article
C2 - 27577549
AN - SCOPUS:84984858079
VL - 17
JO - BMC Musculoskeletal Disorders
JF - BMC Musculoskeletal Disorders
SN - 1471-2474
IS - 1
M1 - 375
ER -