scholarly journals A Concise and Comprehensive Description of Shoulder Pathology and Procedures: The 4D Code System

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Laurent Lafosse ◽  
Tom Van Isacker ◽  
Joseph B. Wilson ◽  
Lewis L. Shi
Keyword(s):  
Glenohumeral Joint ◽  
Biceps Tendon ◽  
Fatty Infiltration ◽  
Three Dimensional ◽  
Classification Systems ◽  
Shoulder Pathology ◽  
Comprehensive Picture ◽  
Calcific Tendonitis ◽  
Simple Language ◽  
Long Head

Background. We introduce a novel description system of shoulder pathoanatomy. Its goal is to provide a comprehensive three-dimensional picture, with an additional component of time; thus, we call it the 4D code.Methods. Each line of the code starts with right versus left and a time designation. The pillar components are recorded regardless of pathology; they include subscapularis, long head of biceps tendon, supraspinatus, infraspinatus, and teres minor. Secondary elements can be added if there is observed pathology, including acromioclavicular joint, glenohumeral joint, labrum, tear configuration, location and extent of partial cuff tear, calcific tendonitis, fatty infiltration, and neuropathy.Results. We provide two illustrative examples of patients which show the ease and effectiveness of the 4D code. With a few simple lines, significant amount of information about patients’ pathology, surgery, and recovery can be easily conveyed.Discussion. We utilize existing validated classification systems for parts of the shoulder and provide a frame work to build a comprehensive picture. The alphanumeric code provides a simple language that is universally understood. The 4D code is concise yet complete. It seeks to improve efficiency and accuracy of the communication, documentation, and visualization of shoulder pathology within individual practices and between providers.

scholarly journals Suprapectoral vs. Intra Articular Biceps Tenodesis: A Comparison of Clinical Outcomes

2018 ◽  
Vol 6 (7_suppl4) ◽  
pp. 2325967118S0010
Author(s):  
Brian M. Godshaw ◽  
Nicholas Kolodychuk ◽  
Benjamin Bryan Browning ◽  
Gerard Williams ◽  
Rachel Burdette ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Outcome Measures ◽  
Glenohumeral Joint ◽  
Short Form ◽  
Biceps Tendon ◽  
Biceps Tenodesis ◽  
Measured Time ◽  
Long Head ◽  
Distally Based

Objectives: The long head of the biceps tendon is a frequent pain generator within the shoulder. It is subjected to trauma and wear within the glenohumeral joint and within the intertubercular groove. Tenodesis of this tendon is a common treatment option for patients experiencing biceps tendon related pain. There are several different techniques to perform this procedure. Proximal intra-articular tenodesis can be performed but leaves the tendon within the intertubercular groove. Alternatively, suprapectoral tenodesis can be performed removing the tendon from the bicipital groove and sheath while avoiding conversion to an open procedure. Further, suprapectoral tenodesis limits complications associated with an open distally based incision. Several studies have compared these techniques to tenotomy or open-subpectoral tenodesis. This is the first study to directly compare patient outcomes between intra-articular and suprapectoral bicep tenodeses. Methods: Retrospective review of patients undergoing intra-articular or suprapectoral arthroscopic biceps tenodesis from 2010 - 2015. Clinical outcomes were measured at set intervals post-operatively (3 months, 6 months, and 12 months) and compared to pre-operative scores. Outcome measures included short form-12, both physical (PSF) and mental (MSF) component scores, and the American Shoulder and Elbow Surgeons score (ASES). Results: A total of 96 patients were available for this study, 43 had intra-articular tenodesis and 56 had suprapectoral tenodesis. There was no difference in functional outcomes between intra and extra articular biceps tenodesis at 1-year post-operative. The intra-articular group had a quicker improvement in scores with the greatest increase at 3 months post-operatively, specifically in PSF group (p=0.016): however, this difference leveled off at 1-year follow up (p=0.238). The intra-articular group had greater absolute scores at all measured time points, but not significantly. Both groups showed improvement in all outcome measures and there was found to be no difference in changes for ASES, PSF, or MSF (p=0.262, p=0.489, and p=0.907 respectively). Conclusion: This study demonstrates that both intra-articular and surpapectoral techniques are acceptable options for biceps tenodesis. Despite leaving the biceps tendon within the glenohumeral joint and intertubercular groove, the intra-articular technique offers similar improvement in outcome measures to the suprapectoral technique.

scholarly journals Shoulder biomechanics in normal and selected pathological conditions

2020 ◽  
Vol 5 (8) ◽  
pp. 508-518
Author(s):  
Patrick Goetti ◽  
Patrick J. Denard ◽  
Philippe Collin ◽  
Mohamed Ibrahim ◽  
Pierre Hoffmeyer ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Glenohumeral Joint ◽  
Biceps Tendon ◽  
Tendon Healing ◽  
Upward Migration ◽  
Superior Capsular Reconstruction ◽  
Long Head ◽  
Favourable Environment ◽  
The Stability ◽  
Cuff Repair

The stability of the glenohumeral joint depends on soft tissue stabilizers, bone morphology and dynamic stabilizers such as the rotator cuff and long head of the biceps tendon. Shoulder stabilization techniques include anatomic procedures such as repair of the labrum or restoration of bone loss, but also non-anatomic options such as remplissage or tendon transfers. Rotator cuff repair should restore the cuff anatomy, reattach the rotator cable and respect the coracoacromial arch whenever possible. Tendon transfer, superior capsular reconstruction or balloon implantation have been proposed for irreparable lesions. Shoulder rehabilitation should focus on restoring balanced glenohumeral and scapular force couples in order to avoid an upward migration of the humeral head and secondary cuff impingement. The primary goal of cuff repair is to be as anatomic as possible and to create a biomechanically favourable environment for tendon healing. Cite this article: EFORT Open Rev 2020;5:508-518. DOI: 10.1302/2058-5241.5.200006

scholarly journals Arthroscopic Tenotomy of the Long Head of the Biceps Tendon and Section of the Anterior Joint Capsule Produce Moderate Osteoarthritic Changes in an Experimental Sheep Model

2021 ◽  
Vol 18 (14) ◽  
pp. 7471
Author(s):  
Umile Giuseppe Longo ◽  
Francisco Forriol ◽  
Vincenzo Candela ◽  
Salvatore Maria Tecce ◽  
Sergio De Salvatore ◽  
...  
Keyword(s):  
Shoulder Joint ◽  
Glenohumeral Joint ◽  
Biceps Tendon ◽  
Joint Capsule ◽  
Quantitative Mri ◽  
Degenerative Changes ◽  
Histological Evaluation ◽  
Sheep Model ◽  
Long Head ◽  
Development And Evolution

Osteoarthritis (OA) of the glenohumeral (GH) joint is a common cause of shoulder pain, resulting in considerable invalidity. Unfortunately, the study of its pathogenesis is challenging. Models of OA are necessary to identify specific targets for therapy and to be able to interfere with the development and evolution of OA. This study aims to assess the effect of an arthroscopic tenotomy of the long head of the biceps tendon (LHBT) and section of the anterior glenohumeral joint capsule on the ovine glenohumeral joint. In addition, the authors aim to validate and evaluate the reliability of a modified semi-quantitative MRI score to assess joint degeneration in a sheep’s shoulder. Eight skeletally mature sheep received an arthroscopic tenotomy of the LHBT and section of the anterior joint capsule and were euthanized four months after surgery. All animals tolerated the surgery well, and no complication was recorded for six weeks. Moderate degenerative changes to the ovine shoulder joint were found on MRI and histological evaluation. The arthroscopic tenotomy of the LHBT and the anterior glenohumeral joint capsule section caused moderate degenerative changes to the ovine shoulder joint.

scholarly journals Ultrasound guided injection of the rotator interval – Gaurav-Botchu technique

2021 ◽  
Vol 21 (84) ◽  
pp. e77-e79
Author(s):  
Gaurav Kant Sharma ◽  
◽  
Rajesh Botchu ◽  
Keyword(s):  
Glenohumeral Joint ◽  
Biceps Tendon ◽  
Lateral Approach ◽  
Rotator Interval ◽  
Ultrasound Guided ◽  
Target Zone ◽  
Coracohumeral Ligament ◽  
Biceps Tendon Rupture ◽  
Long Head ◽  
Joint Injections

Ultrasound-guided injection of the shoulder via the rotator interval can be challenging. The procedure is used for arthrograms, hydrodilatation and intra-articular glenohumeral joint injections. The conventional approach to the rotator interval is from lateral to medial. However, the placement of the needle in the target zone i.e. between the coracohumeral ligament and the long head of the biceps, can be difficult and challenging. Inadvertent injection performed with the needle in the long head of the biceps tendon can result in a biceps tendon rupture. We describe a new method (Gaurav-Botchu technique) to access the target zone (between the coracohumeral ligament and the long head of the biceps tendon) via a medial to lateral approach, which increases the target zone.

The role of negative intraarticular pressure and the long head of biceps tendon on passive stability of the glenohumeral joint

2013 ◽  
Vol 22 (1) ◽  
pp. 94-101 ◽  
Author(s):  
Susan Alexander ◽  
Dominic F.L. Southgate ◽  
Anthony M.J. Bull ◽  
Andrew L. Wallace
Keyword(s):  
Glenohumeral Joint ◽  
Biceps Tendon ◽  
Passive Stability ◽  
Long Head Of Biceps ◽  
Long Head

scholarly journals Atypical tear of the long head of the biceps tendon in a young male adult

2020 ◽  
Vol 13 (1) ◽  
pp. e232936
Author(s):  
Prabjit Ajrawat ◽  
Deven Bhargava ◽  
Mehdi Sadoughi
Keyword(s):  
Glenohumeral Joint ◽  
Biceps Tendon ◽  
Young Male ◽  
Proximal Portion ◽  
Male Adult ◽  
Steroid Abuse ◽  
First Case ◽  
Anabolic Steroid Abuse ◽  
Long Head ◽  
The Right

A 34-year-old man, with previous anabolic steroid abuse, presented with right shoulder pain following an underhand bowling swing. Examination indicated a Popeye sign of the right biceps, and positive Speeds, Yergason and O’Brian’s tests. MRI indicated a complete tear of the intra-articular portion of the long head of biceps tendon (LHBT). Interestingly, the tear occurred within the glenohumeral joint allowing the proximal portion of the LHBT to uniquely coil and fold on itself deep to the subscapularis causing mechanical symptoms. He was treated conservatively with physical therapy but failed to achieve pain relief and proceeded with arthroscopic debridement of the folded portion of the LHBT stump, which significantly improved clinical outcomes at 18 months postoperative. We report the first case of an LHBT tear during bowling in a young adult with a rare occurrence of the proximal portion of the LHBT uniquely coiling and folding on itself deep to the subscapularis.

3D MRI of the Shoulder

2021 ◽  
Vol 25 (03) ◽  
pp. 480-487
Author(s):  
Steven P. Daniels ◽  
Soterios Gyftopoulos
Keyword(s):  
3D Imaging ◽  
Comprehensive Evaluation ◽  
Biceps Tendon ◽  
Three Dimensional ◽  
Added Value ◽  
Glenohumeral Instability ◽  
Long Head Biceps Tendon ◽  
Long Head ◽  
The Many ◽  
Long Head Biceps

AbstractMagnetic resonance imaging provides a comprehensive evaluation of the shoulder including the rotator cuff muscles and tendons, glenoid labrum, long head biceps tendon, and glenohumeral and acromioclavicular joint articulations. Most institutions use two-dimensional sequences acquired in all three imaging planes to accurately evaluate the many important structures of the shoulder. Recently, the addition of three-dimensional (3D) acquisitions with 3D reconstructions has become clinically feasible and helped improve our understanding of several important pathologic conditions, allowing us to provide added value for referring clinicians. This article briefly describes techniques used in 3D imaging of the shoulder and discusses applications of these techniques including measuring glenoid bone loss in anterior glenohumeral instability. We also review the literature on routine 3D imaging for the evaluation of common shoulder abnormalities as 3D imaging will likely become more common as imaging software continues to improve.

scholarly journals Shoulder Injury Related to Vaccine Administration (SIRVA): An Occupational Case Report

2019 ◽  
Vol 67 (10) ◽  
pp. 501-505 ◽  
Author(s):  
Michael Shahbaz ◽  
Paul D. Blanc ◽  
Sandra J. Domeracki ◽  
Sandeep Guntur
Keyword(s):  
Glenohumeral Joint ◽  
Medical Center ◽  
Biceps Tendon ◽  
Limited Range ◽  
Biomedical Literature ◽  
Joint Effusion ◽  
Shoulder Injury ◽  
Vaccine Administration ◽  
Magnetic Resonance Imaging Mri ◽  
Long Head

Transient shoulder pain is a common complaint following intramuscular vaccine administration into the deltoid. More severe vaccination-associated shoulder complications comprising of weakness and decreased range of motion are categorized under the construct “shoulder injury related to vaccine administration” (SIRVA) that subsumes both subjective and objective findings consistent with injury. We describe the presentation and management of a case of SIRVA in a health care worker following seasonal influenza vaccine administration as part of a hospital-based employee health program and review the relevant biomedical literature. We present a case from a single medical center. All data were collected by professionals in occupational health by interviewing, performing physical examinations, and reviewing medical records associated with the injured worker. Severe pain and limited range of shoulder motion developed following an influenza vaccination that was administered using a poorly positioned, larger than recommended needle. Magnetic resonance imaging (MRI) demonstrated moderate glenohumeral joint effusion and synovitis, with fluid accumulating in the subscapularis recess within 1 week of injury. At 8 months after initial injury, MRI showed persistent mild tenosynovitis of the long head of the biceps tendon, interval accumulation of a large glenohumeral joint effusion, and infraspinatus tendinitis with subjacent reactive bone marrow edema. The affected worker experienced work restrictions but had no complete lost workdays to date due to the injury. Occupationally related SIRVA is a preventable adverse event that should be considered in workplace vaccine administration programs, and appropriate education and training provided to vaccine administrators to address this.

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