Surgical repair of a biceps tendon rupture: A systematic review

Objective. To evaluate the methodological quality of Bicep tendon rupture surgical repair studies found in the current literature. Data sources. Pubmed (1950--2009), CINAHL (1985--2009), SPORTdiscus (1987--2009), MEDLINE, Google Scholar, SCIENCE DIRECT (1980--2009) from December 2009 to January 2009 were searched using the terms Distal biceps tendon, Proximal Biceps tendon, Long head of the biceps tendon individually. Second the term biceps tendon rupture was combined with each of the following words: anatomy, surgical treatment, conservative treatment, imaging, conservative treatment, biomechanics, etiology, and epidemiology. Third, Citations were cross-referenced from studies to include literature not found in the original search. Study selection . Studies were selected based on the following inclusion criteria: (1) The studies were written in or translated to English; (2) The term bicep tendon rupture must be present in the title; (3) The abstract must include the name of the surgical repair technique used; and (4) Bicep tendon pain or dysfunction must be the chief complaint. Exclusion criteria consisted of any study that included a surgical repair to a rotator cuff muscle. Data extraction . All the studies that met the inclusion criteria were collected and evaluated using the Coleman Method scale. First each study was read completely without the use of the Coleman Method scoring checklist. Next, each article was read a second time using the Coleman Method scoring checklist by both evaluators. Based on the check list the studies were awarded points on whether the scored information was included. Finally when all of the studies were scored the two evaluators come together and compared their scores for each study and discrepancies were discussed until an agreement was reached. Data synthesis. The ten studies that were collected varied in subject population, type of surgical procedure performed was either a tenotomy or tenodesis, and whether the study conducted was a prospective or retrospective design and level of methodological quality. The subject population of the studies varied from 12 to 307. The Methodological quality of the studies according to the Coleman Method score ranged from 12 to 76, with the average mean score of 63.9. Conclusion. There is a lack of high quality methodological studies in the current literature, although some quality studies do exist. However, the number of quality studies is small making it difficult to draw strong conclusions as to which surgical technique provides the best outcome for the patient