scholarly journals Arthroscopic Superior Capsule Reconstruction Using Autologous Fascia Lata and Biceps Tendon Augmentation

2021 ◽  
Author(s):  
Chen-Heng Hsu ◽  
Chih-Hao Chiu ◽  
Chun-Jui Weng ◽  
Kuo-Yau Hsu ◽  
Yi-Sheng Chan ◽  
...  
Keyword(s):  
Biceps Tendon ◽  
Fascia Lata ◽  
Superior Capsule Reconstruction

scholarly journals Arthroscopic superior capsule reconstruction using autologous fascia lata and biceps tendon augmentation

2020 ◽  
Author(s):  
Chen-Heng Hsu ◽  
Chih-Hao Chiu ◽  
Chun-Jui Weng ◽  
Kuo-Yau Hsu ◽  
Yi-Sheng Chan ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Biceps Tendon ◽  
Fascia Lata ◽  
Cuff Tear ◽  
Novel Technique ◽  
Superior Capsule Reconstruction ◽  
Fascia Graft ◽  
Irreparable Rotator Cuff Tear

Abstract Background: While arthroscopic superior capsule reconstruction (SCR) has been recently introduced to treat irreparable rotator cuff tear with encouraging outcomes, graft options and fixation remain debated. The purpose of this article is to describe a novel technique and present preliminary results in using long head of biceps tendon (LHBT) as augmentation for SCR with fascia lata autograft.Methods: Retrospective analysis was performed on 18 patients undergoing arthroscopic SCR with LHBT augmentation for irreparable rotator cuff tear between October 2017 and November 2019. Preoperative radiographic survey confirmed massive rotator cuff tear with moderate to severe muscle fatty infiltration and availability of LHBT. Fascia lata autograft harvested from ipsilateral thigh was folded and securely sutured. The folded fascia graft was then introduced through standard anterolateral portal and fixed to superior glenoid superiorly and greater tuberosity laterally with suture anchors. Anteriorly, fascia lata graft was sutured with proximal portion of LHBT instead of subscapularis tendon. A full coverage of rotator cuff defect by facial graft was then confirmed arthroscopically to allow tension-free suturing between posterior margin of fascia graft and residual infraspinatus tendon. Postoperative abduction brace and regular follow-up was arranged.Results: Being intact in 4 patients and either partially torn or subluxed in 14 patients, LHBT in all 18 patients were available for augmentation surgery. Preliminary functional survey revealed encouraging outcomes with a mean follow-up of 11.5 months. Nine patients with more than one year follow-up regained full forward elevation; ASES improved from 24.3 to 90.2. Acromiohumeral distance improved from 3.3 mm to 8.6 mm with radiographic analysis in those 9 patients.Conclusions: Arthroscopically LHBT augmented SCR is a novel technique and can be one of feasible opinions for irreparable rotator cuff tear.

scholarly journals Arthroscopic superior capsule reconstruction using autologous fascia lata and biceps tendon augmentation

2020 ◽  
Author(s):  
Chen-Heng Hsu ◽  
Chih-Hao Chiu ◽  
Chun-Jui Weng ◽  
Kuo-Yau Hsu ◽  
Yi-Sheng Chan ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Biceps Tendon ◽  
Fascia Lata ◽  
Cuff Tear ◽  
Novel Technique ◽  
Superior Capsule Reconstruction ◽  
Fascia Graft ◽  
Irreparable Rotator Cuff Tear

Abstract Background While arthroscopic superior capsule reconstruction (SCR) has been recently introduced to treat irreparable rotator cuff tear with encouraging outcomes, graft options and fixation remain debated. The purpose of this article is to describe a novel technique and present preliminary results in using long head of biceps tendon (LHBT) as augmentation for SCR with fascia lata autograft. Methods Retrospective analysis was performed on 18 patients undergoing arthroscopic SCR with LHBT augmentation for irreparable rotator cuff tear between October 2017 and November 2019. Preoperative radiographic survey confirmed massive rotator cuff tear with moderate to severe muscle fatty infiltration and availability of LHBT. Fascia lata autograft harvested from ipsilateral thigh was folded and securely sutured. The folded fascia graft was then introduced through standard anterolateral portal and fixed to superior glenoid superiorly and greater tuberosity laterally with suture anchors. Anteriorly, fascia lata graft was sutured with proximal portion of LHBT instead of subscapularis tendon. A full coverage of rotator cuff defect by facial graft was then confirmed arthroscopically to allow tension-free suturing between posterior margin of fascia graft and residual infraspinatus tendon. Postoperative abduction brace and regular follow-up was arranged. Results Being intact in 4 patients and either partially torn or subluxed in 14 patients, LHBT in all 18 patients were available for augmentation surgery. Preliminary functional survey revealed encouraging outcomes with a mean follow-up of 11.5 months. Nine patients with more one year follow-up regained full forward elevation; ASES improved from 24.3 to 90.2. Acromiohumeral distance improved from 3.3 mm to 8.6 mm with radiographic analysis in those 9 patients. Conclusions Arthroscopically LHBT augmented SCR is a novel technique and can be one of feasible opinions for irreparable rotator cuff tear.

Superior Capsule Reconstruction with the Mid-Thigh Fascia Lata

2021 ◽  
pp. 149-159
Author(s):  
Clara de Campos Azevedo ◽  
Ana Catarina Ângelo
Keyword(s):  
Fascia Lata ◽  
Superior Capsule Reconstruction

Use of the Medial Upper Arm Fascia to Bridge Biceps Tendon Defects

2006 ◽  
Vol 31 (3) ◽  
pp. 334-336 ◽  
Author(s):  
M. M. AL-QATTAN
Keyword(s):  
Achilles Tendon ◽  
Latissimus Dorsi ◽  
Biceps Tendon ◽  
Fascia Lata ◽  
Semitendinosus Tendon ◽  
Latissimus Dorsi Flap ◽  
Upper Arm ◽  
Flexor Carpi Radialis ◽  
Flap Coverage

Options to bridge biceps tendon defects which have been described in the literature include fascia lata, semitendinosus tendon, flexor carpi radialis, Achilles tendon–calcaneus composite allografts and Achilles tendon allografts. In this study, the author reports the use of the upper arm fascia. This option is considered most suitable for patients who require simultaneous pedicled latissimus dorsi flap coverage of concurrent traumatic complex anterior elbow defects.

Reconstruction of Chronic Distal Biceps Tendon Rupture using Fascia Lata Autograft

2012 ◽  
Vol 2 (1) ◽  
pp. 55-59
Author(s):  
Nathan T Morrell ◽  
Deana M Mercer ◽  
Moheb S Moneim
Keyword(s):  
Tendon Rupture ◽  
Biceps Tendon ◽  
Donor Site ◽  
Elbow Flexion ◽  
Fascia Lata ◽  
Suture Anchors ◽  
Distal Biceps Tendon ◽  
Distal Biceps ◽  
Biceps Tendon Rupture ◽  
Tendon Ruptures

ABSTRACT Introduction Distal biceps tendon ruptures are a rare injury and surgical reconstruction is typically recommended for chronic ruptures. There is no consensus regarding the most appropriate reconstruction technique. We present our experience with fascia lata autograft reconstructions of chronic distal biceps tendon ruptures using a modified single incision technique and distal fixation with suture anchors. Materials and methods We retrospectively reviewed the outcome of 12 male patients with chronic distal biceps tendon ruptures who had reconstruction using a fascia lata autograft through a single anterior approach. The age ranged from 29 to 62 years. The average delay to surgery was 26.5 weeks (range 6-68 weeks). A modified single anterior incision was utilized for all patients. Fascia lata autograft was attached distally to the bicipital tuberosity using suture anchors. Tension was set with the elbow in 50° of flexion. The average follow-up was 14.5 months (range 1.5-66 months). All patients were treated by the senior author (MSM). Results Eleven patients (92%) reported subjective improvement in elbow flexion and supination strength, as well as painless range of motion. The average elbow flexion/ extension arc was 126° (5° flexion to 131° flexion) and the average supination/pronation arc was 167 degrees (87° pronation to 80° supination). Five patients underwent isokinetic flexion strength testing which revealed a restoration of 86% of strength when compared to the uninvolved side. Four patients underwent supination isokinetic strength testing which revealed a restoration of 87% of strength when compared to uninvolved side. Four patients reported numbness in the superficial radial nerve distribution that recovered within 12 months. There were no cases of heterotopic ossification or graft rupture. There was one case of wound dehiscence at the elbow that required local flap coverage and went on to heal uneventfully. Aside from a small muscle bulge at the donor site, there were no donor site complications. Conclusion To our knowledge, this is the largest case series of patients undergoing distal biceps tendon reconstruction using fascia lata autograft. Our study has demonstrated a low complication rate with functional results similar to those reported in the literature utilizing a similar technique. We conclude that this technique offers a surgical treatment alternative that yields satisfactory functional outcomes with a low risk of complication. Morrell NT, Mercer DM, Moneim MS. Reconstruction of Chronic Distal Biceps Tendon Rupture using Fascia Lata Autograft. The Duke Orthop J 2012;2(1):55-59.

scholarly journals Superior Capsular Reconstruction of the Shoulder Using the Long Head of the Biceps Tendon: A Systematic Review of Surgical Techniques and Clinical Outcomes

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 229
Author(s):  
Dimitrios Kitridis ◽  
Christos Yiannakopoulos ◽  
Chris Sinopidis ◽  
Panagiotis Givissis ◽  
Nikiforos Galanis
Keyword(s):  
Pain Intensity ◽  
Clinical Studies ◽  
Biceps Tendon ◽  
Surgical Techniques ◽  
Fascia Lata ◽  
Long Term Results ◽  
Cochrane Library ◽  
Superior Capsular Reconstruction ◽  
Functional Scores ◽  
Long Head

Background and Objectives: Superior capsular reconstruction (SCR) with the use of a fascia lata autograft or a dermal allograft is an established treatment in treating irreparable rotator cuff (RC) tears. The long head of the biceps tendon (LHBT) has been recently proposed as an alternative graft for SCR. The purpose of this study was to present the surgical techniques and clinical studies utilizing the LHBT for SCR. Material and Methods: Medline, Scopus, and the Cochrane library were searched for relevant studies up to December 2020. The primary outcomes were pain intensity improvement and the incidence of RC and LHBT graft retears. Secondary outcomes were functional scores and acromiohumeral distance (AHD) improvements. Results: Nine studies described surgical techniques of SCR using the LHBT, and four clinical studies reported the outcomes of the technique. The mean pain intensity improved from 4.9 ± 2.3 to 1.6 ± 1.5 in terms of the visual analog scale, exceeding the minimum clinically important difference for adequate pain relief. Significant improvements were also noted in functional scores and AHD. When compared with other repair techniques for massive RC tears, i.e., the double-row repair, the transosseous-equivalent technique with absorbable patch reinforcement, and the traditional SCR with a fascia lata autograft, there were no significant differences in pain and function improvements. Conclusion: SCR using the LHBT is a useful treatment option for massive RC tears; it is equally effective with the traditional SCR and other established techniques. It presents numerous advantages being a safe, easy, time-saving, and cost-effective method. The only precondition for the technique is the presence of an intact LHBT. Additional clinical trials are necessary to determine which treatment is superior for treating massive RC tears, as well as to evaluate the long-term results of the technique.

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