Cadaveric evaluation of canine arthroscopic bicipital tenotomy

2002 ◽  
Vol 15 (04) ◽  
pp. 215-222 ◽  
Author(s):  
K. S. Schulz ◽  
K. Ingel ◽  
I. G. Holsworth
Keyword(s):  
Elbow Flexion ◽  
Tendon Sheath ◽  
Anatomical Location ◽  
Anatomical Dissection ◽  
Tendon Length ◽  
Camera Port ◽  
Shoulder Joints ◽  
Biceps Tenotomy ◽  
Thoracic Limb ◽  
Distal Tendon

SummaryThe purposes of this study were to determine the optimal portal location, limb position and instrumentation for arthroscopic assisted biceps tenotomy as an alternative to open tendon transection and humeral tenodesis and to evaluate anatomical location and support of the tendon following transection.Eight canine cadaver shoulder joints underwent arthroscopic visualization of bicipital tendon length via cranio-lateral and caudo-lateral camera portals in a variety of thoracic limb positions to determine maximal tendon length visualization by anatomical marking. Comparison of tenotomy time and ease was compared between radio frequency microscalpel, blade and arthroscopic shaver. Gross anatomical dissection was performed post-tenotomy to record tendon lengths, locations and supporting structures.The cranio-lateral camera port in conjunction with combined moderate shoulder and elbow flexion optimized tendon visualization, accessible length, and instrumentation ease. Visualized tendon length varied from 39-76% of total tendon length. Tenotomy times were lowest via blade and were unable to be performed with the shaver. After tenotomy the distal tendon segment remained loosely tethered within the in- tertubercular groove at the level of the intertubercular ligament by tendon sheath and capsular attachments.Biceps tenotomy is readily performed with standard arthroscopic equipment. Appropriate limb positioning and modification of previously described portals allows maximal access. Immediately posttenotomy the distal tendon is loosely maintained within the bicipital groove by tendon sheath and capsular attachments.

scholarly journals Measurements of Tendon Movement Within the Bicipital Groove After Suprapectoral Intra-articular Biceps Tenodesis in a Cadaveric Model

2021 ◽  
Vol 9 (1) ◽  
pp. 232596712097753
Author(s):  
Brian J. Kelly ◽  
Alan W. Reynolds ◽  
Patrick J. Schimoler ◽  
Alexander Kharlamov ◽  
Mark Carl Miller ◽  
...  
Keyword(s):  
Biceps Tendon ◽  
Full Range ◽  
Elbow Flexion ◽  
Biceps Tenodesis ◽  
Bicipital Groove ◽  
Biceps Tenotomy ◽  
Flexion Extension ◽  
Before And After ◽  
Long Head ◽  
Scapular Motion

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.

The Sesamoids of the Metacarpo-Phalangeal Joint of the Thumb: An Anatomical and Clinical Study

1989 ◽  
Vol 14 (2) ◽  
pp. 244-247
Author(s):  
J. D. GIBEAULT ◽  
P. SABA ◽  
H. HOENECKE ◽  
A. GRAHAM
Keyword(s):  
Clinical Study ◽  
Flexor Tendon ◽  
Tendon Sheath ◽  
Volar Plate ◽  
Histological Studies ◽  
Anatomical Dissection ◽  
Flexor Tendon Sheath

Two unusual cases of injury to the sesamoids of the M.P. joint of the thumb are described. An anatomical dissection of the M.P. volar plate region, including the sesamoids, was undertaken to delineate the details of the sesamoids’ relationship to the M.P. joint, flexor tendon, flexor tendon sheath and capsule of the joint. Histological studies were carried out to demonstrate a tendinous extension of the muscles that attach to the sesamoids.

Bilateral Elbow Flexion Reconstruction with Functioning Free Muscle Transfer for Obstetric Brachial Plexus Palsy

2002 ◽  
Vol 27 (5) ◽  
pp. 484-486 ◽  
Author(s):  
A. S. BALIARSING ◽  
K. DOI ◽  
Y. HATTORI
Keyword(s):  
Brachial Plexus ◽  
Elbow Flexion ◽  
Gracilis Muscle ◽  
Brachial Plexus Palsy ◽  
Muscle Transfer ◽  
Nerve Roots ◽  
Obstetric Brachial Plexus Palsy ◽  
Shoulder Joints ◽  
Muscle Transfers ◽  
Obstetric Brachial Plexus

A child suffered a bilateral obstetric brachial plexus palsy involving the C5 and C6 nerve roots. Abduction of the shoulder joints had recovered by 1 year, but elbow flexion did not recover on either side. Free gracilis muscle transfers were performed on both sides, at an interval of 6 months, to achieve elbow flexion. The spinal accessory nerve was used as the donor nerve.

Cutaneous Receptors Contribute to Kinesthesia at the Index Finger, Elbow, and Knee

2005 ◽  
Vol 94 (3) ◽  
pp. 1699-1706 ◽  
Author(s):  
D. F. Collins ◽  
K. M. Refshauge ◽  
G. Todd ◽  
S. C. Gandevia
Keyword(s):  
Muscle Spindle ◽  
Knee Flexion ◽  
Index Finger ◽  
Elbow Flexion ◽  
Contralateral Side ◽  
The Body ◽  
Triceps Brachii ◽  
Joint Flexion ◽  
Skin Stretch ◽  
Distal Tendon

The neural mechanisms underlying the sense of joint position and movement remain controversial. While cutaneous receptors are known to contribute to kinesthesia for the fingers, the present experiments test the hypothesis that they contribute at other major joints. Illusory movements were evoked at the interphalangeal (IP) joints of the index finger, the elbow, and the knee by stimulation of populations of cutaneous and muscle spindle receptors, both separately and together. Subjects matched perceived movements with voluntary movements of homologous joints on the contralateral side. Cutaneous receptors were activated by stretch of the skin (using 2 intensities of stretch) and vibration activated muscle spindle receptors. Stimuli were designed to activate receptors that discharge during joint flexion. For the index finger, vibration was applied over the extensor tendons on the dorsum of the hand, to evoke illusory metacarpophalangeal (MCP) joint flexion, and skin stretch was delivered around the IP joints. The strong skin stretch evoked the illusion of flexion of the proximal IP joint in 6/8 subjects (12 ± 5°, mean ± SE). For the group, strong skin stretch delivered during vibration increased the perceived flexion of the proximal IP joint by eight times with a concomitant decrease in perceived flexion of the MCP joint compared with vibration alone ( P < 0.05). For the elbow, vibration was applied over the distal tendon of triceps brachii and skin stretch over the dorsal forearm. When delivered alone, strong skin stretch evoked illusory elbow flexion in 5/10 subjects (9 ± 4°). Simultaneous strong skin stretch and vibration increased the illusory elbow flexion for the group by 1.5 times compared with vibration ( P < 0.05). For the knee, vibration was applied over the patellar tendon and skin stretch over the thigh. Skin stretch alone evoked illusory knee flexion in 3/10 subjects (8 ± 4°) and when delivered during vibration, perceived knee flexion increased for the group by 1.4 times compared with vibration ( P < 0.05). Hence inputs from cutaneous receptors, muscle receptors, and combined inputs from both receptors likely subserve kinesthesia at joints throughout the body.

A Comparison of Forearm Supination and Elbow Flexion Strength in Patients With Long Head of the Biceps Tenotomy or Tenodesis

2011 ◽  
Vol 27 (1) ◽  
pp. 9-16 ◽  
Author(s):  
John R. Shank ◽  
Steven B. Singleton ◽  
Sepp Braun ◽  
Michael J. Kissenberth ◽  
Arun Ramappa ◽  
...  
Keyword(s):  
Elbow Flexion ◽  
Biceps Tenotomy ◽  
Long Head ◽  
Flexion Strength

scholarly journals A Rare Case of Triceps Brachii Injury after Electrocution

2017 ◽  
Vol 10 (01) ◽  
pp. 046-048
Author(s):  
Debora Lana ◽  
Luigi Tarallo ◽  
Fabio Catani
Keyword(s):  
Elbow Flexion ◽  
Tendon Injury ◽  
Triceps Brachii ◽  
Musculotendinous Junction ◽  
Steroid Injections ◽  
Direct Trauma ◽  
Triceps Brachii Muscle ◽  
Uncommon Case ◽  
Type Of Injury ◽  
Distal Tendon

AbstractInjuries of the triceps brachii muscle are a rare entity and mostly concern its distal tendon. These represent the least common of all muscle and tendons injuries. The most common reported causes are repeated strong physical efforts, a fall on an outstretched forearm when a sudden deceleration is put on contract triceps, or a direct trauma. High-dosed and prolonged corticosteroid therapies, repeated local steroid injections, chronic renal failure, diabetes, rheumatoid arthritis, hyperparathyroidism, and osteogenesis imperfecta are reported as systemic causes. Even rarer are lesions of muscle fibers and avulsions or rupture at its musculotendinous junction, and these can be caused by direct trauma or by forced elbow flexion during triceps contraction. To the best of our knowledge, there is no article in the literature describing this type of injury that occurred after electrocution. In this article, we report an uncommon case of intramuscular tear associated with insertional distal tendon injury occurred in a man survived to high-voltage electric discharge.

scholarly journals Three-Dimensional Assessment of Upper Limb Proprioception via a Wearable Exoskeleton

2021 ◽  
Vol 11 (6) ◽  
pp. 2615
Author(s):  
Elisa Galofaro ◽  
Erika D’Antonio ◽  
Fabrizio Patané ◽  
Maura Casadio ◽  
Lorenzo Masia
Keyword(s):  
Neurological Diseases ◽  
Scientific Evidence ◽  
Three Dimensional ◽  
Sensory Information ◽  
Elbow Flexion ◽  
Muscle Spindles ◽  
Shoulder Abduction ◽  
Anatomical Location ◽  
Preferred Direction ◽  
Flexion Extension

Proprioception—the sense of body segment’s position and movement—plays a crucial role in human motor control, integrating the sensory information necessary for the correct execution of daily life activities. Despite scientific evidence recognizes that several neurological diseases hamper proprioceptive encoding with consequent inability to correctly perform movements, proprioceptive assessment in clinical settings is still limited to standard scales. Literature on physiology of upper limb’s proprioception is mainly focused on experimental approaches involving planar setups, while the present work provides a novel paradigm for assessing proprioception during single—and multi-joint matching tasks in a three-dimensional workspace. To such extent, a six-degrees of freedom exoskeleton, ALEx-RS (Arm Light Exoskeleton Rehab Station), was used to evaluate 18 healthy subjects’ abilities in matching proprioceptive targets during combined single and multi-joint arm’s movements: shoulder abduction/adduction, shoulder flexion/extension, and elbow flexion/extension. Results provided evidence that proprioceptive abilities depend on the number of joints simultaneously involved in the task and on their anatomical location, since muscle spindles work along their preferred direction, modulating the streaming of sensory information accordingly. These findings suggest solutions for clinical sensorimotor evaluation after neurological disease, where assessing proprioceptive deficits can improve the recovery path and complement the rehabilitation outcomes.

Functional contribution of T1 to the brachial plexus in infants

2011 ◽  
Vol 37 (3) ◽  
pp. 237-243 ◽  
Author(s):  
A. Fattah ◽  
C. G. Curtis ◽  
A. M. R. Agur ◽  
H. M. Clarke
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
External Rotation ◽  
Physiological Activity ◽  
Arm Movement ◽  
Elbow Flexion ◽  
Early Postoperative Period ◽  
Active Movement ◽  
Anatomical Dissection ◽  
Obstetrical Brachial Plexus Palsy

To determine the contribution of the T1 root to movements of the upper limb in infancy, 40 infants presenting with obstetrical brachial plexus palsy who underwent resection and reconstruction of all brachial plexus roots with the exception of the T1 root were assessed in the early postoperative period. The movements of the limb were recorded using the Hospital for Sick Children active movement scale and demonstrated considerable variability. All movements of the upper limb were observed in this group with the exception of external rotation of the shoulder and elbow flexion. Classical accounts of the function of T1 have limited its activity to the small muscles of the hand and were based on anatomical dissection, brachial plexus injuries and electrical stimulation. By contrast, this study isolated the physiological activity of T1 and analysed the functional contribution of this root to arm movement. We show a greater than generally recognized contribution of T1 to the function of the upper limb in infants.

scholarly journals Biceps Tenotomy Vs Tenodesis in Patients Younger Than 50, Systematic Review

2021 ◽  
Vol 9 (12) ◽  
pp. 2311-2314
Author(s):  
Mona Mohammed
Keyword(s):  
Rotator Cuff ◽  
Constant Score ◽  
Meta Analysis ◽  
Elbow Flexion ◽  
Strength Loss ◽  
Analysis Data ◽  
Clinical Results ◽  
Shoulder Function ◽  
Biceps Tenotomy ◽  
Popeye Deformity

Abstract: Purpose: The objective of this meta-analysis was to offer an up-to-date comparison of clinical outcomes of tenotomy and tenodesis in the surgical treatment of LHB tendinopathy in patients under the age of 50. Methods: A literature search was conducted in EMBASE, PubMed/Medline and the Cochrane database from January 2010 to Dec 2020. All studies that compared the clinical results of LHB tenotomy and tenodesis were included. Results: The Meta- analysis data were from nine studies that comprised 669 participants who had LHB tenotomy or tenodesis with or without other shoulder surgeries (mainly rotator cuff repairs). There were no clinically significant changes in the Constant score, the American Shoulder and Elbow Society Score, shoulder pain, elbow flexion strength loss, or forearm supination strength when tenodesis and tenotomy were compared in randomized studies. Patients who have tenodesis were less likely to develop a Popeye deformity. Conclusion: In a meta-analysis, patients who had a tenotomy were more likely to have a Popeye deformity. There is no evidencebased benefit of LHB tenodesis over tenotomy in terms of shoulder function, shoulder discomfort, or biceps-related strength, according to a large number of studies. It's unknown whether LHB tenodesis is beneficial to some patient populations, such as children. Keywords: Biceps, Tenotomy, Tenodesis, Rotator cuff, Meta-analysis

Sign in / Sign up

Export Citation Format

Share Document