Arthroscopic Release of the Long Head of the Biceps Tendon

Background Treatment of chronic, refractory biceps tendinitis remains controversial. The authors sought to evaluate clinical and functional outcomes of arthroscopic release of the long head of the biceps tendon. Hypothesis In specific cases of refractory biceps tendinitis, site-specific release of the long head of the biceps tendon may yield relief of pain and symptoms. Study Design Case series; Level of evidence, 4. Methods Fifty-four patients diagnosed with biceps tendinitis underwent arthroscopic release of the long head of the biceps tendon as an isolated procedure or as part of a concomitant shoulder procedure over a 2-year period. Patients were not excluded for concomitant shoulder abnormality, including degenerative joint disease, rotator cuff tears, Bankart lesions, or instability. Nine of 40 patients had an isolated arthroscopic release of the biceps tendon. At a minimum of 2 years, the American Shoulder and Elbow Surgeons; the University of California, Los Angeles; and the L'Insalata shoulder questionnaires as well as ipsilateral and contralateral metrics were used for evaluation. Results The L'Insalata; University of California, Los Angeles; and American Shoulder and Elbow Surgeons scores were 77.6, 27.6, and 75.6, respectively. Seventy percent had a Popeye sign at rest or during active elbow flexion; 82.7% of men and 36.5% of women had a positive Popeye sign (P <. 05); 68% were rated as good, very good, or excellent. No patient reported arm pain at rest distally or proximally; 38% of patients complained of fatigue discomfort (soreness) isolated to the biceps muscle after resisted elbow flexion. Conclusion Arthroscopic release of the long head of the biceps tendon is an appropriate and reliable intervention for patients with chronic, refractory biceps tendinitis. Cosmetic deformity presenting as a positive Popeye sign and fatigue discomfort were the primary complaints. Clinical Relevance Although tenotomy is not the ideal intervention for patients of all ages with various shoulder abnormalities, data suggest that it may be an acceptable surgical intervention for a specifically selected cohort of individuals.

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Modified Arthroscopic Double-Row Technique for Isolated Biceps Tenodesis

10.21203/rs.3.rs-112212/v1 ◽

2020 ◽

Author(s):

Renlong Li ◽

Kun Tao

Keyword(s):

Los Angeles ◽

Visual Analogue Scale ◽

Scale Score ◽

Visual Analogue Scale Score ◽

Analogue Scale ◽

Biceps Tendon ◽

University Of California ◽

Double Row ◽

Long Head ◽

Shoulder Score

Abstract BackgroundDue to certain complications with single anchor fixation reported in the literature, we proposed a modified double-row technique for arthroscopic biceps tenodesis.MethodsFrom June 2014 to January 2018, 42 patients with isolated lesions of the long head of the biceps tendon were treated with an arthroscopic modified double-row technique. The Constant-Murley shoulder score, University of California Los Angeles shoulder score, and visual analogue scale score were evaluated preoperatively and postoperatively.ResultsAll patients were followed up for an average of 28.6 months. The mean Constant-Murley shoulder score, University of California Los Angeles shoulder score, and visual analogue scale score were significantly improved from 52.6, 12.8, and 6.4 preoperatively to 94.3, 33.1, and 0.6 at the last follow-up, respectively (P<0.001 for all). There was no postoperative incidence of persist bicipital groove pain or Popeye sign reported.ConclusionArthroscopic tenodesis with a modified double-row technique could achieve satisfactory efficacy in the treatment of lesions of the long head of the biceps tendon. This method could be an alternative and reliable option for the treatment of the long head of the biceps tendon lesion.

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Proximal Biceps Tenodesis Incorporated into Supraspinatus Repair: A Case Series and Technical Description

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120975354 ◽

2021 ◽

Vol 9 (1) ◽

pp. 232596712097535

Author(s):

Joshua M. Veenstra ◽

Andrew G. Geeslin ◽

Christopher W. Uggen

Keyword(s):

Rotator Cuff ◽

Biceps Tendon ◽

Tendon Repair ◽

Case Series ◽

Supraspinatus Tendon ◽

Biceps Tenodesis ◽

Arm Pain ◽

Patient Reported ◽

Tendon Pathology

Background: Biceps tendon pathology is commonly associated with rotator cuff tears. A multitude of different biceps tenodesis techniques have been studied, with limited clinical data on arthroscopic biceps tenodesis techniques incorporated into rotator cuff repairs. Purpose: To evaluate the outcomes of an arthroscopic biceps tenodesis incorporated into a supraspinatus tendon repair. Study Design: Case series; Level of evidence, 4. Methods: Patients undergoing surgical treatment of supraspinatus tendon tears with concomitant biceps tendon pathology were prospectively enrolled from 2014 to 2015. A total of 32 patients underwent combined biceps tenodesis and rotator cuff repair; of these, 19 patients were evaluated for a mean of 2.0 years. The primary outcome measures were the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES; patient self-report and physician assessment sections), visual analog scale (VAS) pain score, responses to specific biceps-related assessments, and biceps specific physical exam findings. Results: Patient-reported ASES scores improved from 45.9 preoperatively to 91.6 at the 2-year follow-up ( P < .001). Pain VAS scores improved from 5.2 preoperatively to 0.7 at the 2-year follow-up ( P < .001). Preoperatively, 18 patients had a positive Speed test; all were negative at 5 months postoperatively, and 21 patients had bicipital groove tenderness preoperatively, which resolved in all 21 patients at 5 months postoperatively. At the 2-year follow-up, 2 patients had cramping arm pain and 4 patients noticed a change in arm contour. There were no reoperations. No complications occurred in the study group. Conclusion: Arthroscopic biceps tenodesis incorporated into a supraspinatus tendon repair was a safe and reliable option for biceps pathology with a concomitant rotator cuff tear.

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

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120977538 ◽

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.

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

Biomedical Journal ◽

10.4103/2319-4170.106145 ◽

2012 ◽

Vol 35 (3) ◽

pp. 263 ◽

Cited By ~ 2

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

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Long Head of the Biceps Pathology Combined with Rotator Cuff Tears

Advances in Orthopedics ◽

10.1155/2012/405472 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 15

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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Augmented Repair of Large to Massive Delaminated Rotator Cuff Tears With Autologous Long Head of the Biceps Tendon Graft: The Arthroscopic “Cuff-Plus” Technique

Arthroscopy Techniques ◽

10.1016/j.eats.2020.07.011 ◽

2020 ◽

Vol 9 (11) ◽

pp. e1683-e1688

Author(s):

Giuseppe Milano ◽

Giacomo Marchi ◽

Giuseppe Bertoni ◽

Niccolò Vaisitti ◽

Stefano Galli ◽

...

Keyword(s):

Rotator Cuff ◽

Biceps Tendon ◽

Tendon Graft ◽

Rotator Cuff Tears ◽

Long Head

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Validation of the Super Simple Hip score combined with the University of California, Los Angeles activity scale for younger patients

Hip International ◽

10.1177/1120700019835444 ◽

2019 ◽

Vol 30 (2) ◽

pp. 181-186 ◽

Cited By ~ 1

Author(s):

Johan C N de Vlieger ◽

Paulien M van Kampen ◽

Hans-Erik Henkus ◽

Loes W A H van Beers ◽

Julius Wolkenfelt ◽

...

Keyword(s):

Los Angeles ◽

Ceiling Effect ◽

University Of California ◽

Minimal Important Change ◽

Younger Patients ◽

Patient Reported ◽

Ucla Score ◽

Activity Scale ◽

Activity Rating ◽

The University

Introduction: Patient-reported outcome measures (PROMs) are used increasingly, but for young patients with hip complaints, traditional scoring systems have a ceiling effect that limits their usability. We developed and validated the Super Simple Hip (SUSHI) score, a PROM specifically targeted at younger patients with hip complaints. Although the SUSHI measured hip problems adequately, the responsiveness of its activity rating component was considered inadequate. Consequently, we replaced the activity rating component by the University of California, Los Angeles (UCLA) activity scale. The aim of this study was to validate the resulting new 10-item SUSHI-UCLA score. Methods: A prospective multicentre observational cohort study was performed. Patients between 18 and 59 years, who visited the Orthopaedic Department with hip complaints, completed the SUSHI-UCLA and hip osteoarthritis outcome score (HOOS) twice before their 1st appointment, and once 16 months after. Results: 142 patients were included (mean age 49 years; SD 8.8). The SUSHI-UCLA score correlated well with the HOOS, both before and after treatment (Spearman’s rho = 0.739 and 0.847, respectively, both p < 0.001). The responsiveness of both the SUSHI-UCLA score and the UCLA activity scale was high (standardised response mean = 2.51 and 1.35 respectively). The reproducibility was good (interclass correlation coefficient for agreement = 0.962). The minimal important change was 21.2. No significant floor or ceiling effect was observed. Conclusion: The SUSHI-UCLA score is an adequate PROM to measure hip complaints in younger patients and includes a validated activity rating.

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