The role of the bicipital groove in tendopathy of the long biceps tendon

1999 ◽  
Vol 8 (5) ◽  
pp. 419-424 ◽  
Author(s):  
M Pfahler ◽  
S Branner ◽  
H.J Refior
2021 ◽  
Vol 9 (1) ◽  
pp. 232596712097753
Author(s):  
Brian J. Kelly ◽  
Alan W. Reynolds ◽  
Patrick J. Schimoler ◽  
Alexander Kharlamov ◽  
Mark Carl Miller ◽  
...  

Background: Lesions of the long head of the biceps can be successfully treated with biceps tenotomy or tenodesis when surgical management is elected. The advantage of a tenodesis is that it prevents the potential development of a cosmetic deformity or cramping muscle pain. Proponents of a subpectoral tenodesis believe that “groove pain” may remain a problem after suprapectoral tenodesis as a result of persistent motion of the tendon within the bicipital groove. Purpose/Hypothesis: To evaluate the motion of the biceps tendon within the bicipital groove before and after a suprapectoral intra-articular tenodesis. The hypothesis was that there would be minimal to no motion of the biceps tendon within the bicipital groove after tenodesis. Study Design: Controlled laboratory study. Methods: Six fresh-frozen cadaveric arms were dissected to expose the long head of the biceps tendon as well as the bicipital groove. Inclinometers and fiducials (optical markers) were used to measure the motions of the scapula, forearm, and biceps tendon through a full range of shoulder and elbow motions. A suprapectoral biceps tenodesis was then performed, and the motions were repeated. The motion of the biceps tendon was quantified as a function of scapular or forearm motion in each plane, both before and after the tenodesis. Results: There was minimal motion of the native biceps tendon during elbow flexion and extension but significant motion during all planes of scapular motion before tenodesis, with the most motion occurring during shoulder flexion-extension (20.73 ± 8.21 mm). The motion of the biceps tendon after tenodesis was significantly reduced during every plane of scapular motion compared with the native state ( P < .01 in all planes of motion), with a maximum motion of only 1.57 mm. Conclusion: There was a statistically significant reduction in motion of the biceps tendon in all planes of scapular motion after the intra-articular biceps tenodesis. The motion of the biceps tendon within the bicipital groove was essentially eliminated after the suprapectoral biceps tenodesis. Clinical Relevance: This arthroscopic suprapectoral tenodesis technique can significantly reduce motion of the biceps tendon within the groove in this cadaveric study, possibly reducing the likelihood of groove pain in the clinical setting.


2017 ◽  
Vol 25 (2) ◽  
pp. 230949901771719 ◽  
Author(s):  
Jae Chul Yoo ◽  
Geethan Iyyampillai ◽  
Dongjun Park ◽  
Kyoung-Hwan Koh

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1825.2-1825
Author(s):  
M. G. Abdelzaher ◽  
S. Tharwat ◽  
A. Abdelkhalek ◽  
A. Abdelsalam

Background:Rheumatoid arthritis (RA) is a chronic inflammatory disease that results in progressive destruction of structural components of the joints1.It commonly affects the shoulder leading to pain, tenderness and decreased range of motion2.Increased shoulder pain has been found to correlate strongly with disease severity3, however there is little information available in the literature regarding shoulder pathologies in asymptomatic RA patients.Objectives:To determine the prevalence of pathologies in asymptomatic shoulders in rheumatoid arthritis patients and role of ultrasound to detect it.Methods:A cross-sectional study including two groups, first group included 36 RA patients, meeting the ACR/EULAR classification criteria for RA with no shoulder complaints. The second group included 36 healthy control subjects of similar age groups and sex, with no shoulder complaints. They were recruited from rheumatology outpatient clinic in Mansoura University Hospital. Only asymptomatic shoulders of both groups were examined clinically by inspection, palpation and special tests, then examined by ultrasound using Toshiba Xario 200 machine with 13 MHz superficial probe including biceps tendon, subscapularis tendon, supraspinatus tendon, subacromial subdeltoid (SASD) bursa, infraspinatus tendon, posterior glenohumeral joint for effusion or synovitis, acromioclavicular joint and humeral head for erosions. Findings of both groups were compared to each other.Results:Asymptomatic shoulders in RA patients showed significant number of pathologies in 72% of the examined patients in comparison with healthy subjects (17%). According to frequency, humeral erosions were detected in 12 patients (33%), acromioclavicular osteoarthritis in 8 patients (22%), biceps tenosynovitis, supraspinatus tendinopathy, glenohumeral effusion in 6 patients (17%), subscapularis tendinopathy in 4 patients (11.%), SASD bursitis in 2 patients (6%), Infraspinatus tendinopathy in 1 patient (3%).The healthy group showed less number of pathologies including supraspinatus tendinopathy 3 (8%), acromioclavicular osteoarthritis 2 (6%), humeral erosions 1 (3%).Conclusion:A significant high rate of different pathologies can be present in shoulders of RA patients despite negative history and normal physical examination. Ultrasound can be used for early detection and better management before irreversible joint destruction.References:[1]Weishaupt D, Schweitzer ME (2004) MR imaging of septic arthritis and rheumatoid arthritis of the shoulder. Magn Reson Imaging Clin N Am 12:111–124[2]Varache S, Cornec D, Morvan J, et al. Diagnostic accuracy of acr/eular 2010 criteria for rheumatoid arthritis in a 2-year cohort. The Journal of rheumatology. 2011; 38(7): 1250-1257.[3]Van de Sande MA, De Groot JH, Rozing PM. Clinical implications of rotator cuff degeneration in the rheumatic shoulder. Arthritis care & research. 2008; 59(3): 317-324.Disclosure of Interests:None declared


2021 ◽  
Vol 10 (3) ◽  
pp. 432
Author(s):  
Moritz Riedl ◽  
Agnes Mayr ◽  
Stefan Greiner ◽  
Christian Pfeifer ◽  
Isabella Weiss ◽  
...  

(1) Introduction: Several surgical therapy options for the treatment of pathologies of the long biceps tendon (LHB) have been established. However, tenotomy, as well as established tenodesis techniques, has disadvantages, such as cosmetic deformities, functional impairments and residual shoulder pain. This study presents the first clinical and structural results of the recently introduced loop tenodesis procedure for the LHB, developed to overcome these issues. (2) Methods: 37 patients (11 women, 26 men, mean age 52 years), who underwent loop tenodesis of the LHB were examined six months after surgery. For the clinical evaluation the Constant score, as well as the LHB score, were used, complemented by elbow flexion and supination strength measurements. The integrity of the tenodesis construct was evaluated indirectly by sonographic detection of the LHB in the bicipital groove. (3) Results: Both, the overall Constant score as well as the LHB score showed significant improvements six months postoperatively, as compared to the preoperative value. Fourteen patients (38%) presented an examiner-dependent upper arm deformity, although only five patients (13%) reported subjective cosmetic deformities. Both, flexion and supination strength were preserved compared to the preoperative level. In 35 patients (95%), the tenodesis in the bicipital groove was proofed sonographically. (4) Conclusion: The loop tenodesis of the LHB provides good-to-excellent overall clinical results after a short-term follow-up of six month. The incidence of cosmetic deformities was inferior compared to conventional therapy options (tenotomy and anchor tenodesis).


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