Debridement and Long Head of the Biceps Tenotomy in Revision Rotator Cuff Tears

2021 ◽  
pp. 75-81
Author(s):  
Daniel P. Berthold ◽  
Lukas N. Muench ◽  
Augustus D. Mazzocca ◽  
Knut Beitzel
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tears ◽  
Biceps Tenotomy ◽  
Long Head

scholarly journals A meta-analysis comparing tenotomy or tenodesis for lesions of the long head of the biceps tendon with concomitant reparable rotator cuff tears

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Yuyan Na ◽  
Yong Zhu ◽  
Yuting Shi ◽  
Yizhong Ren ◽  
Ting Zhang ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Constant Score ◽  
Biceps Tendon ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Rotator Cuff Tears ◽  
Biceps Tenodesis ◽  
Biceps Tenotomy ◽  
Long Head ◽  
Supination Strength

Abstract Background The best treatment for lesions of the long head of the biceps tendon (LHBT) with concomitant reparable rotator cuff tears is still controversial. The purpose of the meta-analysis was to compare clinical outcomes of biceps tenotomy and tenodesis for LHBT lesions. Methods A literature retrieval was conducted in MEDLINE, Embase, and Cochrane Library from 1979 to March 2018. Comparative studies (level of evidence I or II) comparing tenotomy and tenodesis for LHBT lesions with concomitant reparable rotator cuff tears were included. Risk of bias for all included studies was assessed using the Cochrane Collaboration’s risk of bias tool. Clinical outcomes compared were Popeye sign, Constant score, VAS pain score, cramping pain, elbow flexion and forearm supination strength, and re-tear of the rotator cuff. Results Two randomized controlled trials (RCTs) and five prospective cohort studies (PCS) with 288 biceps tenotomy patients and 303 biceps tenodesis patients were included in this review. Tenotomy resulted in significantly greater rates of Popeye sign (RR, 2.70 [95% CI, 1.80 to 4.04]; P < 0.01) and a less favorable Constant score (MD, − 1.09 [95% CI, − 1.90 to − 0.28]; P < 0.01) compared to tenodesis. No significant heterogeneity was found between the two groups across all parameters except forearm supination strength. Conclusions The current evidence indicates that biceps tenodesis for LHBT lesions with concomitant reparable rotator cuff tears results in decreased rate of Popeye sign and improved Constant score compared to biceps tenotomy. Trial registration PROSPERO, CRD42018105504. Registered on 13 August 2018.

scholarly journals Biceps Tenotomy Does not Affect the Functional Outcomes of Patients Treated with Spacer Implantation Due to Massive Irreparable Rotator Cuff Tears

2017 ◽  
Vol 11 (1) ◽  
pp. 1577-1584 ◽  
Author(s):  
Eran Maman ◽  
Ori Safran ◽  
Shaul Beyth ◽  
Gavriel Mozes ◽  
Assaf Dekel ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Functional Outcomes ◽  
Constant Score ◽  
Shoulder Function ◽  
Rotator Cuff Tears ◽  
Shoulder Dysfunction ◽  
Biceps Tenotomy ◽  
Long Head ◽  
Post Implantation

Background:Lesions of the long head of the biceps (LHB) tendon are frequently associated with massive rotator cuff tears (RCT) and may be responsible for shoulder pain and disability.Objective:This study aimed to evaluate functional outcomes of arthroscopic biodegradable spacer implantation with or without biceps tenotomy as treatment for persistent shoulder dysfunction and pain due to a massive irreparable RCT.Methods:A total of 48 patients were implanted with the subacromial spacer using arthroscopic approach with or without biceps tenotomy. All patients were assessed for up to 12 months post-implantation and 18 patients were assessed for at least 24 months (and a maximum of 40 months). Improvement in shoulder function was assessed using Constant score.Results:Subacromial spacer implantation was performed arthroscopically in 48 patients. The mean total Constant score increased from 36 at baseline to 67 points at 12 months post implantation. Patients who underwent LHB tenotomy in addition to the subacromial spacer presented similar improvement of their shoulder function and score compared to the group that was treated with the spacer alone.Conclusion:Current study demonstrates that spacer implantation in this patient population provides significant improvement in function and decreases the pain. Additional LHB tenotomy did not influence the postoperative results during the follow-up.

scholarly journals Arthroscopic isolated long head of biceps tenotomy in patients with degenerative rotator cuff tears: mid-term clinical results and prognostic factors

2020 ◽  
Author(s):  
Egbert J. D. Veen ◽  
Ashvin V. Boeddha ◽  
Ronald L. Diercks ◽  
Ydo V. Kleinlugtenbelt ◽  
Ellie B. M. Landman ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Rotator Cuff ◽  
Clinical Results ◽  
Rotator Cuff Tears ◽  
Long Head Of Biceps ◽  
Biceps Tenotomy ◽  
Long Head ◽  
Acromiohumeral Distance ◽  
And Function

Abstract Introduction The long head of biceps tendon is frequently involved in degenerative rotator cuff tears. Therefore, this study explored the clinical results of an isolated biceps tenotomy and identified prognostic factors for improvement in pain and function. Materials and methods Between 2008 and 2017, an arthroscopic isolated biceps tenotomy was performed on 64 patients with a degenerative rotator cuff tear (> 65 years). Primary outcome was patient-perceived improvement in pain and function. Potential prognostic factors for improvement in pain and function were identified. Results A perceived improvement in pain was reported in 78% of the patients at three months after surgery and in 75% at a mean follow-up of 4.2 years (1–7 years; n = 55). A perceived improvement in function was observed in 49% of patients at three months and in 76% of patients at follow-up. Patients with a preoperatively normal acromiohumeral distance (> 10 mm) reported an improvement in pain and function significantly more often. Retraction of the supraspinatus tendon Patte 3 was significantly associated with worse functional outcome. Conclusions A biceps tenotomy can be a reliable treatment option for patients with symptomatic degenerative cuff tears who fail conservative treatment and have a normal acromiohumeral distance (> 10 mm).

Biceps tenotomy versus soft-tissue tenodesis in females aged 60 years and older with rotator cuff tears

2021 ◽  
Author(s):  
Itaru Kawashima ◽  
Shinya Ishizuka ◽  
Hideki Hiraiwa ◽  
Shiro Imagama ◽  
Norimasa Takahashi ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Rotator Cuff ◽  
Rotator Cuff Tears ◽  
Biceps Tenotomy

scholarly journals Biceps Detachment Preserves Joint Function in a Chronic Massive Rotator Cuff Tear Rat Model

2018 ◽  
Vol 46 (14) ◽  
pp. 3486-3494 ◽  
Author(s):  
Mengcun Chen ◽  
Snehal S. Shetye ◽  
Julianne Huegel ◽  
Corinne N. Riggin ◽  
Daniel J. Gittings ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Joint ◽  
Shoulder Function ◽  
Rotator Cuff Tears ◽  
Subscapularis Tendon ◽  
Joint Function ◽  
Massive Rotator Cuff Tears ◽  
Sham Surgery ◽  
Biceps Tenotomy

Background: Lesions of the long head of the biceps tendon are often associated with massive rotator cuff tears (MRCTs), and biceps tenotomy is frequently performed for pain relief and functional reservation. However, the efficacy and safety of biceps tenotomy regarding the effects on the surrounding tissues in chronic MRCT are unclear. Hypothesis: Biceps tenotomy would result in improved mechanical and histological properties of the intact subscapularis tendon and improved in vivo shoulder function while not compromising glenoid cartilage properties. Study Design: Controlled laboratory study. Methods: Right supraspinatus and infraspinatus tendons were detached in 25 male Sprague-Dawley rats, followed by 4 weeks of cage activity to create a chronic MRCT condition. Animals were randomly divided into 2 groups and received either biceps tenotomy (n = 11) or sham surgery (n = 14) and were sacrificed 4 weeks thereafter. Forelimb gait and ground-reaction forces were recorded 1 day before the tendon detachment (baseline), 1 day before the surgical intervention (biceps tenotomy or sham), and 3, 7, 10, 14, 21, and 28 days after the intervention to assess in vivo shoulder joint function. The subscapularis tendon and glenoid cartilage were randomly allocated for mechanical testing or histologic assessment after the sacrifice. Results: Compared with sham surgery, biceps tenotomy partially restored the in vivo shoulder joint function, with several gait and ground-reaction force parameters returning closer to preinjury baseline values at 4 weeks. With biceps tenotomy, mechanical properties of the subscapularis tendons were improved, while mechanical properties and histological Mankin scores of the glenoid cartilage were not diminished when compared with the sham group. Conclusion: Biceps tenotomy in the presence of chronic MRCT partially preserves overall shoulder function and potentially restores subscapularis tendon health without causing detrimental effects to joint cartilage. This laboratory study adds to the growing literature regarding the protective effects of biceps tenotomy on the shoulder joint in a chronic MRCT model. Clinical Relevance: This study provides important basic science evidence supporting the use of biceps tenotomy in patients with massive rotator cuff tears.

Reparable rotator cuff tears with concomitant long-head biceps lesions: tenotomy or tenotomy/tenodesis?

2012 ◽  
Vol 20 (12) ◽  
pp. 2553-2558 ◽  
Author(s):  
Angelo De Carli ◽  
Antonio Vadalà ◽  
Edoardo Zanzotto ◽  
Guido Zampar ◽  
Mario Vetrano ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tears ◽  
Long Head ◽  
Long Head Biceps

scholarly journals Classification and analysis of pathology of the long head of the biceps tendon in complete rotator cuff tears

2012 ◽  
Vol 35 (3) ◽  
pp. 263 ◽  
Author(s):  
Chih-Hwa Chen ◽  
Chih-Hsiang Chang ◽  
Chun-I Su ◽  
Kun-Chung Wang ◽  
I-Chun Wang ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Biceps Tendon ◽  
Rotator Cuff Tears ◽  
Long Head

scholarly journals Long Head of the Biceps Pathology Combined with Rotator Cuff Tears

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Konstantinos Ditsios ◽  
Filon Agathangelidis ◽  
Achilleas Boutsiadis ◽  
Dimitrios Karataglis ◽  
Pericles Papadopoulos
Keyword(s):  
Rotator Cuff ◽  
Biceps Tendon ◽  
Treatment Strategies ◽  
Close Correlation ◽  
Current Treatment ◽  
Rotator Cuff Tears ◽  
Anatomic Structure ◽  
Long Head ◽  
Diagnosis Classification ◽  
Shoulder Pathologies

The long head of the biceps tendon (LHBT) is an anatomic structure commonly involved in painful shoulder conditions as a result of trauma, degeneration, or overuse. Recent studies have pointed out the close correlation between LHBT lesions and rotator cuff (RCT) tears. Clinicians need to take into account the importance of the LHBT in the presence of other shoulder pathologies. This paper provides an up-to-date overview of recent publications on anatomy, pathophysiology, diagnosis, classification, and current treatment strategies.

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