Rupture of the long head biceps tendon treated with tenodesis to the coracoid process. Results at more than 30 years

The rate and reporting of fracture after biceps tenodesis: A systematic review

BACKGROUND

The purpose of this systematic review was to (1) define the cumulative humerus fracture rate after BT and (2) compare how often fracture rate was reported compared to other complications.

METHODS

A systematic review was performed using the PRISMA guidelines.

RESULTS

39 studies reported complications and 30 reported no complications. Of the 39 studies that reported complications, 5 studies reported fracture after BT (n = 669, cumulative incidence of 0.53%). The overall non-fracture complication rate was 12.9%.

DISCUSSION

Due to the relatively high incidence of fracture, surgeons should ensure that this complication is disclosed to patients undergoing BT.

A comprehensive review of the normal, abnormal, and post-operative MRI appearance of the proximal biceps brachii

The biceps brachii myotendinous unit, particularly the long head of the biceps tendon and its labral attachment, is a common cause of shoulder and arm pain. Its complex anatomy and normal variations can present a challenge when interpreting MR images. The purpose of this manuscript is to review the proximal biceps anatomy, variants, pathology, and post-operative appearance as seen on MRI. Recent data regarding the accuracy of clinical examination and MRI will be summarized.

Biceps tenodesis versus biceps tenotomy for biceps tendinitis without rotator cuff tears

Disorders of the long head of the biceps tendon (LHB) are a well-recognised cause of shoulder pain despite the function of the long head of the biceps remaining poorly understood. There has been a dramatic rise in the number of biceps tenodesis procedures being performed in the last decade. This may partly be attributed to concerns regarding residual cosmetic deformity and pain after biceps tenotomy though there is little evidence to suggest that functional outcomes of tenodesis are superior to biceps tenotomy. Current literature focuses on LHB disorders with concomitant rotator cuff tears. The aim of this review is to discuss the anatomy of the LHB, the pathogenesis of tendinopathy of the LHB, indications of biceps tenodesis and tenotomy and compare the current literature on the functional outcomes of these procedures for LHB disorders in the absence of rotator cuff tears.

Biomechanical evaluation of the long head of the biceps brachii tendon fixed by three techniques: a sheep model

OBJECTIVE

To evaluate the biomechanical properties of the fixation of the long head of the biceps brachii into the humeral bone with suture anchors, interference screw, and soft tissue suture, comparing strength, highest traction load, and types of fixation failure.

METHODS

Thirty fresh-frozen sheep shoulders were used, separated into three groups of ten for each technique. After fixation, the tendons were subjected to longitudinal continuous loading, obtaining load-to-failure (N) and displacement (mm).

RESULTS

The mean load-to-failure for suture anchors was 95 ± 35.3 N, 152.7 ± 52.7 N for interference screw, and 104.7 ± 23.54 N for soft tissue technique. There was a statistically significant difference (p < 0.05), with interference screw demonstrating higher load-to-failure than suture anchor fixation (p = 0.00307) and soft tissue (p = 0.00473). The strength of interference screw was also superior when compared with the other two methods (p = 0.0000127 and p = 0.00000295, respectively). There were no differences between suture anchors and soft tissue technique regarding load-to-failure (p = 0.9420) and strength (p = 0.141).

CONCLUSION

Tenodesis of the long head of the biceps brachii with interference screw was stronger than the suture anchors and soft tissue techniques. The other two techniques did not differ between themselves.

Outcomes of tenodesis of the long head of the biceps tendon more than three months after rupture

AIM: To demonstrate that long head of the biceps tendon (LHBT) tenodesis is possible more than 3 mo after rupture.

METHODS: From September 2009 to January 2012 we performed tenodesis of the LHBT in 11 individuals (average age 56.9 years, range 42 to 73) more than 3 mo after rupture. All patients were evaluated by Disabilites of the Arm Shoulder and Hand (DASH) and Mayo outcome scores at an average follow-up of 19.1 mo. We similarly evaluated 5 patients (average age 58.2 years, range 45 to 64) over the same time treated within 3 mo of rupture with an average follow-up of 22.5 mo.

RESULTS: Tenodesis with an interference screw was possible in all patients more than 3 mo after rupture and 90% had good to excellent outcomes but two had recurrent rupture. All of those who had tenodesis less than 3 mo after rupture had good to excellent outcomes and none had recurrent rupture. No statistical difference was found for DASH and Mayo outcome scores between the two groups (P <0.05).

CONCLUSION: Tenodesis of LHBT more than 3 mo following rupture had outcomes similar to tenodesis done within 3 mo of rupture but recurrent rupture occurred in 20%.

Open subpectoral biceps tenodesis: reliable treatment for all biceps tendon pathology

Long head of the biceps (LHB) tendon pathology is a common cause of pain in the shoulder. Pathology encountered includes biceps tendon tears and tendonitis, biceps anchor or superior labral tears, and biceps subluxation or instability. Current surgical treatment options for LHB disorders include tenotomy and tenodesis. Tenodesis prevents cosmetic deformity and biceps cramping with activity. Open subpectoral tenodesis anatomically restores the length-tension relationship of the biceps muscle and removes all diseased biceps from the bicipital groove. The authors present their technique of open subpectoral tenodesis, which demonstrates a high success rate with consistent pain relief and dependable fixation.