Evidence map›Paper›PMID 42178396›Full record

Trial reportArchives of orthopaedic and trauma surgery2026

Loop versus anchor tenodesis of the long head of the biceps tendon: a prospective randomized controlled pilot study.

Martin Bischofreiter, Christina Kölblinger, Michael Gattringer, Alexander Azesberger, Michael Stephan Gruber, Felix Rittenschober, Harald Kindermann, Reinhold Ortmaier

Abstract readRandomized Controlled TrialComparative Study
In one paragraph

Trial report in Archives of orthopaedic and trauma surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Martin BischofreiterDepartment of Orthopedic Surgery (Teaching Department of the Paracelsus Medical University Salzburg), Ordensklinikum Barmherzige Schwestern Linz, Vinzenzgruppe Center of Orthopedic Excellence, 4020, Linz, Austria. m.bischofreiter@utanet.at.
Christina KölblingerDepartment of Orthopedic Surgery (Teaching Department of the Paracelsus Medical University Salzburg), Ordensklinikum Barmherzige Schwestern Linz, Vinzenzgruppe Center of Orthopedic Excellence, 4020, Linz, Austria.
Michael GattringerDepartment of Orthopedic Surgery (Teaching Department of the Paracelsus Medical University Salzburg), Ordensklinikum Barmherzige Schwestern Linz, Vinzenzgruppe Center of Orthopedic Excellence, 4020, Linz, Austria.
Alexander AzesbergerDepartment of Orthopedic Surgery (Teaching Department of the Paracelsus Medical University Salzburg), Ordensklinikum Barmherzige Schwestern Linz, Vinzenzgruppe Center of Orthopedic Excellence, 4020, Linz, Austria.
Michael Stephan GruberDepartment of Orthopedic Surgery (Teaching Department of the Paracelsus Medical University Salzburg), Ordensklinikum Barmherzige Schwestern Linz, Vinzenzgruppe Center of Orthopedic Excellence, 4020, Linz, Austria.
Felix RittenschoberDepartment of Orthopedic Surgery (Teaching Department of the Paracelsus Medical University Salzburg), Ordensklinikum Barmherzige Schwestern Linz, Vinzenzgruppe Center of Orthopedic Excellence, 4020, Linz, Austria.
Harald KindermannDepartment of Marketing and Electronic Business,, University of Applied Sciences Upper Austria, 4400, Steyr, Austria.
Reinhold OrtmaierDepartment of Orthopedic Surgery (Teaching Department of the Paracelsus Medical University Salzburg), Ordensklinikum Barmherzige Schwestern Linz, Vinzenzgruppe Center of Orthopedic Excellence, 4020, Linz, Austria.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe long head of the biceps tendon is a frequent source of anterior shoulder pain, often treated with tenodesis. While anchor tenodesis is well established, it carries risks of implant-related complications. This study evaluates an implant-free "loop tenodesis" technique as a potentially safer and cost-effective alternative.

methodsIn this prospective, double-blinded, randomized exploratory study, 48 patients undergoing arthroscopic biceps tenodesis were randomized to either loop (n = 24) or anchor (n = 24) tenodesis. Clinical outcomes were assessed using ASES, Constant, and DASH scores, as well as range of motion, supination strength, satisfaction, aesthetic appearance, and return-to-sport. Statistical analysis was performed using the Mann-Whitney U and Wilcoxon signed-rank tests to compare non-parametric data.

resultsBoth groups showed significant improvements with similar gains in functional scores. Supination strength recovery was greater in the loop group (103% vs. 93%). There were no significant differences in range of motion or complications. Notably, only the anchor group showed cases of Popeye deformity (2 patients). Return to sport was achieved in 95.3% of patients, typically within 3 months. No revision or implant-related issues occurred.

conclusionLoop tenodesis offers equivalent clinical outcomes to anchor-based techniques, with fewer aesthetic concerns and no implant-associated risks, making it a safe, reliable, and cost-effective alternative for biceps tenodesis.

Indexed as

Shoulder PainSuture AnchorsTendonsTenodesisAdultAgedArthroscopyDouble-Blind MethodFemaleHumansMaleMiddle AgedPilot ProjectsProspective StudiesRange of Motion, ArticularTreatment OutcomeArthroscopicLong head of the biceps tendonLoop tenodesisTenodesis

Identifiers

PMID42178396
PMCPMC13199180

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.