Superior Capsular Reconstruction: A Literature Review About Comparison Autograft Using Long Head Biceps Tendon and Fascia Lata in Rotator Cuff Tear

Cedera otot supraspinatus masif merupakan salah satu cedera yang sering terjadi pada kelompok olahragawan. Pasien akan mengeluhkan nyeri serta kelemahan di bahu yang cedera. Terdapat banyak pilihan teknik untuk menangani cedera tersebut. Penelitian ini akan membandingkan penanganan cedera ini dengan teknik rekonstruksi menggunakan graft dari tendon long head biceps (LHB) dan tendon fascia lata (TFL). Penelitian ini merupakan studi literatur untuk membandingkan teknik dan outcome antara prosedur LHB dan TFL. Dari hasil penelitian, didapatkan hasil bahwa LHB lebih mudah untuk dilakukan dengan efek biomekanika yang sebanding dengan TFL, serta lebih baik dalam hal mencegah migrasi humeral head ke superior. Namun, TFL tampak lebih kuat dan penyembuhannya lebih baik karena mempunyai karakteristik dan struktur biomekanis yang lebih mirip dengan tendon supraspinatus. Kesimpulan penelitian ini, kedua teknik mempunyai keuntungan dan kerugian masing-masing. Namun, kedua teknik sama-sama mempunyai kemampuan yang baik serta dapat menjadi pilihan dalam penanganan cedera otot supraspinatus.

3D MRI of the Shoulder

Magnetic 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.

Impact of shoulder, elbow and forearm position on biceps tendon excursion: A cadaveric study

Purpose: This experimental study investigated the long head biceps tendon (LHBT) excursion that occurs at various positions of the upper limb during tendon stabilizing procedures. We hypothesized that shoulder abduction, elbow extension and forearm pronation would maximize the excursion of the LHBT and potential impacts on tendon stabilization. Materials & Methods: Forequarter specimens from 12 fresh frozen cadavers were used in this study. The study was performed at 0° and 30° of shoulder abduction. Elbow position was either 90° of flexion or full extension with the forearm either in full pronation or supination. A total of 14 combinations of positions were studied. A load of 55 N was applied to the distal biceps. The excursion of the proximal part of LHBT was measured for each of the different positions. Results: At a shoulder position of 30° of flexion, shoulder abduction of 30° created significantly greater excursion than 0° of shoulder abduction ( p < 0.001). Both full extension of the elbow and full pronation of the forearm also showed significant excursion of the tendon when compared to supination ( p < 0.001). Conclusions: The position of the shoulder, elbow and forearm has a significant effect on biceps excursion. Thirty degrees of shoulder abduction and 30° of forward flexion with the elbow in full extension and the forearm in full pronation maximizes excursion. Clinical Relevance: Information about the excursion of the LHBT affected by the position of the upper limb is useful for any biceps tendon stabilizing procedure. During an operation, the position of the upper limb should be monitored in order to maintain a proper anatomic length-tension relationship.