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Polyzos A, Gantsos A, Soranoglou V, Kontogeorgakos VA, Eleftheropoulos A. Arthroscopic Suprapectoral Biceps Tenodesis for Isolated Biceps Tendinopathy: Results From 23 Patients. Cureus 2024; 16:e58912. [PMID: 38800286 PMCID: PMC11118778 DOI: 10.7759/cureus.58912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2024] [Indexed: 05/29/2024] Open
Abstract
INTRODUCTION Pathology affecting the long head of the biceps tendon (LHB) is a common cause of shoulder pain. When conservative treatment fails to resolve symptoms, surgical treatment is the modality of choice. The literature describes many arthroscopic and open techniques using different implants. However, no consensus exists on which procedure yields the greatest improvement. The purpose of this study was to evaluate the effectiveness and safety of arthroscopic suprapectoral biceps tenodesis for treating isolated LHB pathology. MATERIALS AND METHODS We present a case series of 23 patients with isolated LHB pathology who were treated with arthroscopic suprapectoral tenodesis between 2016 and 2022. All surgeries were performed by the same senior surgeon, and patients were assessed preoperatively and one year after the procedure, using the simple shoulder test (SST), Constant score (CS), and visual analog scale (VAS) by the senior surgeon. Statistical analysis was performed using the Wilcoxon Signed Rank test, with significance defined as p < 0.05. RESULTS The CS improved from 68.52 (SD = 1.59) to 98 (SD = 7.1; p < 0.001), the SST improved from 8.78 (SD = 0.998) to 11.21 (SD = 0.42; p < 0.001), and the VAS improved from 8.26 (SD = 0.54) to 0 (SD = 0; p < 0.001) at one-year follow-up. No complications were reported postoperatively or during the follow-up period. CONCLUSIONS Arthroscopic suprapectoral biceps tenodesis significantly improved outcomes at one-year follow-up and can be considered an effective and safe choice when treating LHB pathology.
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Affiliation(s)
- Apostolos Polyzos
- Orthopaedic Surgery, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
| | | | - Vasileios Soranoglou
- Orthopaedics and Traumatology, Athens General Hospital "G. Gennimatas", Athens, GRC
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Maia Dias C, Alçada R, Ribeiro da Silva M. Anchorless Onlay Dynamic Anterior Stabilization of the Shoulder Using a Guided Posterior Double Endobutton Fixation. Arthrosc Tech 2024; 13:102864. [PMID: 38435244 PMCID: PMC10907941 DOI: 10.1016/j.eats.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 10/08/2023] [Indexed: 03/05/2024] Open
Abstract
The treatment of shoulder instability in the presence of a subcritical glenoid defect poses challenges, as simple Bankart seems insufficient, and the Latarjet procedure may be excessive. Recently, a dynamic anterior stabilization technique involving anterior transposition of the long head of the biceps (LHB) through a subscapularis split was described for that purpose. Previously published results demonstrated good short-term results, but several technical pitfalls have also been mentioned. We describe an onlay, anchorless, and intra-articular knotless method of fixing the LHB into the anterior glenoid that provides the important stabilizing "sling effect" of the dynamic anterior stabilization while avoiding some of the pitfalls described by other techniques.
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Affiliation(s)
- Carlos Maia Dias
- Hospital CUF Tejo, Lisbon, Portugal
- Hospital CUF Santarém, Santarém, Portugal
- UCMA Fidelidade, Lisboa, Portugal
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Xu J, Qiao Y, Han K, Xu C, Dong S, Zhao J. Modified Lemaire Lateral Extra-articular Tenodesis With the Iliotibial Band Strip Fixed on the Femoral Cortical Surface Reduces Laxity and Causes Less Overconstraint in the Anterolateral Lesioned Knee: A Biomechanical Study. Arthroscopy 2022; 38:3162-3171. [PMID: 35777678 DOI: 10.1016/j.arthro.2022.06.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 06/03/2022] [Accepted: 06/06/2022] [Indexed: 02/02/2023]
Abstract
PURPOSE To compare the biomechanical effects of femoral cortical surface fixation and intra-tunnel fixation in modified Lemaire tenodesis on the restoration of native kinematics in anterolateral structure-deficient knees. METHODS Eight fresh-frozen cadaveric knees were mounted in a knee-customized jig to evaluate anterior translation in anterior load and internal rotation degree in internal rotation torque at 0°, 30°, 60°, and 90°, as well as anterolateral translation (ALT) in a simulated pivot-shift test at 0°, 15°, 30°, and 45°. Kinematic tests were performed in the following states: intact; anterolateral knee lesion (AL-Les); modified Lemaire lateral extra-articular tenodesis (LET) with the femoral iliotibial band (ITB) strip fixed on the cortical surface (cortical fixation), deep to the lateral collateral ligament (LCL) (deep LET-C); and LET with the femoral ITB strip fixed into a tunnel (intra-tunnel fixation), deep to the LCL (deep LET-IT) or superficial to the LCL (superficial LET-IT). The knee kinematic changes in the AL-Les state and the 3 LET states were compared with each other, with the intact state as the baseline. RESULTS In the AL-Les state, the increased anterior translation instabilities were significantly mitigated by the 3 LETs at 30°, 60°, and 90° (all P < .001), with overconstraint observed in both the deep LET-IT and superficial LET-IT states at 60° (P = .047 and P < .001, respectively) and 90° (both P < .001). Similarly, the 3 LETs significantly reduced the internal rotation instabilities in the AL-Les state at all flexion angles. The superficial LET-IT state overconstrained the knee at 60° (P = .009) and 90° (P < .001) during internal rotation torque, and the deep LET-IT state did so at 60° (P = .012). Furthermore, the ALT instabilities found in the AL-Les state were significantly reduced by the 3 LETs during the simulated pivot-shift test. At 30° and 45°, these LET states resulted in overconstraint when compared with the intact state, but the superficial LET-IT state (P < .001) or deep LET-IT state (P = .016) presented a larger overconstraint than that in the deep LET-C at 45°, respectively. CONCLUSIONS The 3 Lemaire LET procedures evaluated reduced the anterior, internal rotational, and ALT laxities in AL-Les knees and restored these parameters to the native baseline of the intact state at most flexion angles. However, in deep flexion, some overconstraint occurred in all LETs when compared with the intact state, of which the deep LET-C state resulted in less overconstraint in anterior translation and internal rotation than the deep LET-IT and superficial LET-IT states. CLINICAL RELEVANCE This biomechanical study supports using the femoral cortical fixation technique to fix the ITB strip in the modified Lemaire LET, which similarly improves knee kinematic stability and causes less overconstraint compared with conventional intra-tunnel fixation. These findings need more verification in clinical scenarios.
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Affiliation(s)
- Junjie Xu
- Department of Sports Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yi Qiao
- Department of Sports Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Kang Han
- Department of Sports Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Caiqi Xu
- Department of Sports Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Shikui Dong
- Department of Sports Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
| | - Jinzhong Zhao
- Department of Sports Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
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Klemt C, Toderita D, Reilly P, Bull AMJ. Biceps Tenodesis cannot be used as primary treatment option in baseball pitchers with intact rotator cuff muscles. Clin Biomech (Bristol, Avon) 2022; 100:105819. [PMID: 36410224 DOI: 10.1016/j.clinbiomech.2022.105819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/13/2022] [Accepted: 11/08/2022] [Indexed: 11/17/2022]
Abstract
UNLABELLED Background Surgeons remain hesitant to perform biceps tenodesis in athletes with type II superior labrum anterior-to-posterior tears due to the lack of reported clinical outcomes for individual overhead throwing sports and associated concerns that this may predispose the joint to instability. This study aimed to assess the effect of biceps tenodesis on shoulder stability for major overhead throwing sports to aid sport-specific surgical decision-making for athletes with type II superior labrum anterior-to-posterior tears. METHODS This is a combined modelling and experimental study. Motion data and external forces were measured from 13 participants performing five overhead throwing motions. These data served as input into a musculoskeletal shoulder model that quantifies shoulder stability and muscle loading. FINDINGS The loading of the long head of the biceps brachii decreases significantly following biceps tenodesis in three overhead throwing motions (p = 0.02). The loss in joint stability following biceps tenodesis is compensated by a non-significant increase in rotator cuff muscle force which maintains shoulder stability across all overhead throwing motions, except baseball pitching (p = 0.01). The presence of a full-thickness supraspinatus tear post biceps tenodesis further decreases shoulder stability in four of the five overhead throwing motions (p = 0.01). INTERPRETATION The study findings demonstrate that an increase in rotator cuff muscle force maintains joint stability for all overhead throwing motions post biceps tenodesis, except baseball pitching. As the presence of a full-thickness tear of the supraspinatus significantly reduces joint stability, biceps tenodesis may be used as a primary treatment in overhead throwing athletes with intact rotator cuff muscles, except baseball pitchers. LEVEL OF EVIDENCE Controlled Laboratory Study; Level of Evidence 3.
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Affiliation(s)
- Christian Klemt
- Department of Bioengineering, Imperial College London, London, UK
| | - Diana Toderita
- Department of Bioengineering, Imperial College London, London, UK
| | - Peter Reilly
- Department of Bioengineering, Imperial College London, London, UK
| | - Anthony M J Bull
- Department of Bioengineering, Imperial College London, London, UK.
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Hartland AW, Islam R, Teoh KH, Rashid MS. Clinical effectiveness of tenotomy versus tenodesis for long head of biceps pathology: a systematic review and meta-analysis. BMJ Open 2022; 12:e061954. [PMID: 36220319 PMCID: PMC9557260 DOI: 10.1136/bmjopen-2022-061954] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES The comparative clinical effectiveness of common surgical techniques to address long head of biceps (LHB) pathology is unclear. We synthesised the evidence to compare the clinical effectiveness of tenotomy versus tenodesis. DESIGN A systematic review and meta-analysis using the Grading of Recommendations Assessment, Development and Evaluation approach. DATA SOURCES EMBASE, Medline, PsycINFO and the Cochrane Library of randomised controlled trials were searched through 31 October 2021. ELIGIBILITY CRITERIA We included randomised controlled trials, reporting patient reported outcome measures, comparing LHB tenotomy with tenodesis for LHB pathology, with or without concomitant rotator cuff pathology. Studies including patients treated for superior labral anterior-posterior tears were excluded. No language limits were employed. All publications from database inception to 31 October 2021 were included. DATA EXTRACTION AND SYNTHESIS Screening was performed by two authors independently. A third author reviewed the article, where consensus for inclusion was required. Data were extracted by two authors. Data were synthesised using RevMan. Inverse variance statistics and a random effects model were used. RESULTS 860 patients from 11 RCTs (426 tenotomy vs 434 tenodesis) were included. Pooled analysis of patient-reported functional outcome measures data demonstrated comparable outcomes (n=10 studies; 403 tenotomy vs 416 tenodesis; standardised mean difference (SMD): 0.14, 95% CI -0.04 to 0.32, p=0.13). There was no significant difference for pain (Visual Analogue Scale) (n=8 studies; 345 tenotomy vs 350 tenodesis; MD: -0.11, 95% CI -0.28 to 0.06, p=0.21). Tenodesis resulted in a lower rate of Popeye deformity (n=10 studies; 401 tenotomy vs 410 tenodesis; OR: 0.29, 95% CI 0.19 to 0.45, p<0.00001). Tenotomy demonstrated shorter operative time (n=4 studies; 204 tenotomy vs 201 tenodesis; MD 15.2, 95% CI 1.06 to 29.36, p<0.00001). CONCLUSIONS Aside from a lower rate of cosmetic deformity, tenodesis yielded no significant clinical benefit to tenotomy for addressing LHB pathology. PROSPERO REGISTRATION NUMBER CRD42020198658.
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Affiliation(s)
| | - Raisa Islam
- Department of Trauma and Orthopaedic Surgery, Princess Alexandra Hospital, Harlow, UK
| | - Kar Hao Teoh
- Department of Trauma and Orthopaedic Surgery, Princess Alexandra Hospital, Harlow, UK
| | - Mustafa Saad Rashid
- Nuffield Department of Orthopaedics, Rheumatology, and Musckuloskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK
- Nuffield Department of Orthopaedics, Rheumatology, and Musckuloskeletal Sciences, Wrightington Wigan and Leigh NHS Foundation Trust, Wigan, UK
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Taylor AL, Bansal A, Shi BY, Best MJ, Huish EG, Srikumaran U. Optimizing Fixation for Distal Biceps Tendon Repairs: A Systematic Review and Meta-regression of Cadaveric Biomechanical Testing. Am J Sports Med 2021; 49:3125-3131. [PMID: 33596088 DOI: 10.1177/0363546520986999] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Various surgical techniques can be used to repair acute distal biceps tendon (DBT) tears; however, it is unknown which type of repair or implant has the greatest biomechanical strength and presents the lowest risk of type 2 failure. PURPOSE To identify associations between the type of implant or construct used and the biomechanical performance of DBT repairs in a review of human cadaveric studies. STUDY DESIGN Systematic review and meta-regression. METHODS We systematically searched the EMBASE and Medline (PubMed) databases for biomechanical studies that evaluated DBT repair performance in cadaveric specimens. Two independent reviewers extracted data from 14 studies that met our inclusion criteria. The pooled data set was subjected to meta-regression with adjusted failure load (AFL) as the primary outcome variable. Procedural parameters, such as number of sutures, cortices, locking stitches, and whipstitches, served as covariates. Adjusted analysis was performed to determine the differences among implant types. The alpha level was set at .05. RESULTS When using no implant (bone tunnels) as the referent, no fixation type or procedural parameter was significantly better at predicting AFL. Cortical button fixation had the highest AFL (370 N; 95% CI, -2 to 221). In an implant-to-implant comparison, suture anchor alone was significantly weaker than cortical button (154 N; 95% CI, 30 to 279). Constructs using a cortical button and interference screw were not stronger (as measured by AFL) than those using a cortical button alone. The presence of a locking stitch added 113 N (95% CI, 29 to 196) to the AFL. The use of cortical button instead of interference screws or bone tunnels was associated with lower odds of type 2 failure. Avoiding locking stitches and using more sutures in the construct were also associated with lower odds of type 2 failure. CONCLUSION Cortical button fixation is associated with greater construct strength than is suture anchor repair and a lower risk of type 2 failure compared with interference screw fixation or fixation without implants. The addition of an interference screw to cortical button fixation was not associated with increased strength. The presence of a locking stitch added 113 N to the failure load but also increased the odds of type 2 failure.
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Affiliation(s)
| | - Ankit Bansal
- The Johns Hopkins University, Baltimore, Maryland, USA
| | - Brendan Y Shi
- The Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Eric G Huish
- The Johns Hopkins University, Baltimore, Maryland, USA
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Kahan JB, Schneble CA, Applonie R, Nicholson A, Whittall I, Talley-Bruns R, Jorgensen A, LaVette N, Moran J, Ware JK, Lee FY, Blaine TA. Early success of the arthroscopic-assisted locked loop suprapectoral biceps tenodesis. JSES REVIEWS, REPORTS, AND TECHNIQUES 2021; 1:96-101. [PMID: 37588143 PMCID: PMC10426584 DOI: 10.1016/j.xrrt.2021.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
Background There is wide variability in surgical technique for biceps tenodesis. Prior biomechanical studies have demonstrated superior ultimate and fatigue strength with a Krakow-type locked loop when compared with simple suture and lasso-loop configurations; however, this had not yet been clinically studied. The purpose of this study was to assess the short-term results an arthroscopic-assisted locked loop (ALL) suprapectoral biceps tenodesis technique. Methods All patients who underwent an ALL suprapectoral biceps tenodesis by a single surgeon from 2012 and 2019 with a minimum of 12-month follow-up were analyzed. Data collected included demographics, surgical indications, concomitant operative procedures, and postoperative complications of anterior shoulder "groove" pain, "Popeye deformity," biceps muscle cramping pain, and need for revision surgery. Results Forty patients who underwent an ALL suprapectoral biceps tenodesis met inclusion criteria. Patients were 55.6 ± 8.6 years of age, consisting of 28 men (57%) and 21 women (43%). The median follow-up was 19.3 months. At the latest follow-up, 1 (2%) patient had anterior shoulder "groove" pain, and no patients had a Popeye deformity or biceps muscle cramping. There were no revision biceps tenodesis procedures. Conclusion The ALL suprapectoral biceps tenodesis technique results in a low incidence of postoperative complications. At a short-term follow-up of 1 year, no patients had reoperations or revisions for failed biceps tenodesis. Groove pain was nearly absent in this series of patients.
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Affiliation(s)
- Joseph B. Kahan
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, USA
| | | | | | - Allen Nicholson
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Ian Whittall
- Department of Orthopaedic Surgery, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Rachel Talley-Bruns
- Department of Orthopaedic Surgery, Westchester Medical Center, Westchester, NY, USA
| | - Anna Jorgensen
- Department of Orthopaedic Surgery, University of Connecticut School of Medicine, Farmington, CT, USA
| | | | - Jay Moran
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, USA
| | | | - Francis Y. Lee
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, USA
| | - Theodore A. Blaine
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA
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Hurley ET, Anil U, Kingery MT, Pauzenber L, Mullett H, Strauss EJ. Response to Cao et al regarding: "Surgical treatment for long head of the biceps tendinopathy: a network meta-analysis". J Shoulder Elbow Surg 2021; 30:e36-e37. [PMID: 32956778 DOI: 10.1016/j.jse.2020.07.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 07/13/2020] [Indexed: 02/01/2023]
Affiliation(s)
- Eoghan T Hurley
- Division of Sports Medicine, Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA; Department of Trauma and Orthopaedics, Royal College of Surgeons in Ireland, Dublin, Ireland; Sports Surgery Clinic, Dublin, Ireland.
| | - Utkarsh Anil
- Division of Sports Medicine, Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA
| | - Matthew T Kingery
- Division of Sports Medicine, Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA
| | | | | | - Eric J Strauss
- Division of Sports Medicine, Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA
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Eguia FA, Ali I, Bansal A, McFarland EG, Srikumaran U. Minimal clinically important differences after subpectoral biceps tenodesis: definition and retrospective assessment of predictive factors. J Shoulder Elbow Surg 2020; 29:S41-S47. [PMID: 32643609 DOI: 10.1016/j.jse.2020.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 03/27/2020] [Accepted: 04/01/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Minimal clinically important differences (MCIDs) at 1 year after subpectoral biceps tenodesis are unknown for the American Shoulder and Elbow Surgeons (ASES) scale, Subjective Shoulder Value (SSV), and visual analog scale (VAS) for pain. Our objectives were to determine MCIDs for these measures at 1 year after biceps tenodesis and to identify preoperative factors that predict attainment of MCIDs. METHODS We included 52 patients who underwent arthroscopic débridement, decompression, and mini-open biceps tenodesis from 2016-2018. We analyzed age, sex, body mass index value, arm dominance, diagnosis, range of shoulder motion, and preoperative and 1-year postoperative ASES, SSV, and VAS scores. MCIDs were calculated using a distribution-based method of one-half the standard deviation. Preoperative thresholds predictive of MCIDs were calculated with univariate logistic regression. Multiple logistic regression was used to determine factors that predict MCIDs. Significance was set at a 2-tailed P value of <.05. RESULTS MCIDs for the ASES, SSV, and VAS were 13, 12, and 1.6 points, respectively. Preoperative ASES score <59 predicted MCID on the ASES (P = .03); VAS score >3 predicted MCID on the VAS (P < .01); external shoulder rotation >40° predicted MCID on the SSV (P = .02); and age >41 years predicted MCID on the VAS (P = .02). CONCLUSION At 1 year after débridement, decompression, and biceps tenodesis, MCIDs were 13, 12, and 1.6 points for the ASES, SSV, and VAS, respectively. Patients most likely to attain MCIDs were those aged >41 years, those with the most preoperative pain, and those with the poorest preoperative shoulder function.
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Affiliation(s)
- Francisco A Eguia
- Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA
| | - Iman Ali
- Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA
| | - Ankit Bansal
- Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA
| | - Edward G McFarland
- Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA
| | - Uma Srikumaran
- Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA.
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Arthroscopic Onlay Articular Margin Biceps Tenodesis for Long Head of the Biceps Tendon Pathology. Arthrosc Tech 2020; 9:e959-e963. [PMID: 32714805 PMCID: PMC7372504 DOI: 10.1016/j.eats.2020.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 03/15/2020] [Indexed: 02/03/2023] Open
Abstract
The long head of the biceps (LHB) tendon is a common source of shoulder pain. LHB tendon pathology typically occurs with concomitant rotator cuff or labrum injuries but can occasionally occur in isolation as biceps tendinopathy or rupture. Tenodesis has been increasingly used to treat LHB tendon pathology, and numerous techniques have been developed that vary in approach, fixation construct, and fixation location. In this Technical Note, we describe an arthroscopic onlay articular margin biceps tenodesis with suture anchors. This technique has several advantages, namely intra-articular visualization of the tenodesis, strong fixation to high density bone of the articular margin, and most importantly, preservation of the anatomic length-tension relationship.
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