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Biceps Tendon

Yasuhiro Ozasa, Takuro Wada, Kousuke Iba, Toshihiko Yamashita
We report a case of a partial rupture of the distal biceps tendon that was surgically treated using a palmaris longus tendon graft. A 58-year-old man complained of increasing pain with resisted elbow flexion and supination in the antecubital fossa. Magnetic resonance imaging revealed the irregularity of a distal attachment of the biceps brachii and peripheral signal changes. We diagnosed a partial rupture of the distal biceps tendon. Because conservative treatment failed, surgical treatment was performed through a single anterior approach...
March 8, 2018: Acta Orthopaedica et Traumatologica Turcica
George C Andritsos, Dimitrios G Skouteris, Vassilios Psychoyios
Our aim was to evaluate the outcome of our surgical technique for the repair of complete distal biceps tendon rupture in nonprofessional athletes. We examined the effect of our surgical technique in restoring the functionality of 11 injured limbs by correlating the total functional outcome of the repaired limb with their contralateral side.
January 2018: Journal of Orthopaedic Surgery
Eldra W Daniels, David Cole, Bret Jacobs, Shawn F Phillips
Office-based ultrasonography has become increasingly available in many settings, and its use to guide joint and soft tissue injections has increased. Numerous studies have been conducted to evaluate the use of ultrasound-guided injections over traditional landmark-guided injections, with a rapid growth in the literature over the past few years. A comprehensive review of the literature was conducted to demonstrate increased accuracy of ultrasound-guided injections regardless of anatomic location. In the upper extremity, ultrasound-guided injections have been shown to provide superior benefit to landmark-guided injections at the glenohumeral joint, the subacromial space, the biceps tendon sheath, and the joints of the hand and wrist...
February 2018: Orthopaedic Journal of Sports Medicine
Erik Hohmann
Subpectoral tenodesis is performed at the surgical neck of the humerus. In a cadaveric study, the insertion of a unicortical PEEK (polyether ether ketone) screw decreased the torsional load to failure (fracture) by 30% compared with intact control specimens but was similar to unicortical reaming without screw insertion. Placing the biceps tendon into the tunnel and securing it with a unicortical screw reduced the torsional load to failure by 20%. Whether these facts are significant is currently unknown, but the creation of a stress riser is a concern and may possibly result in surgical neck fractures...
March 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Christopher S Ahmad
The optimal treatment of shoulder SLAP tears in high-level baseball players remains highly controversial. In pitchers, many SLAP lesions are found incidentally on magnetic resonance imaging and may in fact be adaptive to the baseball pitcher's mechanics of throwing. Surgical repair of SLAP lesions requires lengthy rehabilitation, and outcomes have been similar to or worse than the results after nonoperative treatment. The treatment option of biceps tenodesis is an appealing alternative to SLAP repair, but the indications and technique of biceps tenodesis in the elite pitcher still need to be defined...
March 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Andrew S Neviaser, Diana C Patterson, Paul J Cagle, Bradford O Parsons, Evan L Flatow
BACKGROUND: Biceps tenodesis reduces the incidence of Popeye deformity occurring with tenotomy, but pain may occur with tenodesis superior to or within the bicipital groove. Arthroscopic suprapectoral tenodesis is an attractive alternative. The purpose of this study was to establish landmarks for arthroscopic suprapectoral tenodesis and determine the appropriate fixation point to optimize muscle tension. METHODS: Twelve fresh cadaveric shoulders were dissected. Urethane polymer was injected into the axillary artery...
February 27, 2018: Journal of Shoulder and Elbow Surgery
Brandon L Roller, Keiichi Kuroki, Chantelle C Bozynski, Ferris M Pfeiffer, James L Cook
The aim of this study was to assess the efficacy and safety of a novel magnesium-based resorbable bone cement (OsteoCrete, Bone Solutions Incorporated) for anchor and tendon fixation. Cadaveric humeral testing involved straight pull-to-failure of rotator cuff suture anchors; OsteoCrete was injected through one anchor, and a second anchor served as the uninjected control. Testing was conducted 15 minutes post-injection. A canine preclinical model was used to evaluate the safety of the following parameters: Rotator cuff repair: A double-row technique was used to repair transected infraspinatus tendons; OsteoCrete was injected through both anchors in one limb, and the contralateral limb served as the uninjected control...
February 2018: American Journal of Orthopedics
Bryan M Saltzman, Michael J Collins, Thomas A Arns, Brian Forsythe
CASE: A snapping biceps femoris tendon, a rare etiology for symptomatic pain in the lateral aspect of the knee, has been reported infrequently. We report 2 cases of an acutely symptomatic unilateral snapping biceps femoris tendon with an intraoperatively intact anomalous insertion onto the tibia, which were treated with anatomic repositioning and "pie-crust" lengthening via a single suture anchor. CONCLUSION: Anatomic repositioning and lengthening is a novel technique that successfully resolved the painful snapping and allowed full return to competitive sports by 6 months postoperatively, with maintenance of improvement at ≥14 months postoperatively...
February 28, 2018: JBJS Case Connector
Chih-Kai Hong, Kai-Lan Hsu, Fa-Chuan Kuan, Cheng-Li Lin, Ming-Long Yeh, Wei-Ren Su
PURPOSE: To compare the biomechanical properties of an transtendinous all-suture anchor technique with the commonly-accepted interference screw technique in a cadaveric model. METHODS: Sixteen fresh-frozen human cadaveric shoulders (mean age, 67.6 ± 5.8 years) were used and were randomly divided into 2 experimental long head of the biceps brachii (LHB) tenodesis groups (n = 8), namely transtendinous all-suture anchor technique and interference screw technique...
February 23, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Lasse Lempainen, Jussi Kosola, Ricard Pruna, Jordi Puigdellivol, Janne Sarimo, Pekka Niemi, Sakari Orava
Background: As compared with injuries involving muscle only, those involving the central hamstring tendon have a worse prognosis. Limited information is available regarding the surgical treatment of central tendon injuries of the hamstrings. Purpose: To describe the operative treatment and outcomes of central tendon injuries of the hamstrings among athletes. Study Design: Case series; Level of evidence, 4. Methods: Eight athletes (6 top level, 2 recreational) with central hamstring tendon injuries underwent magnetic resonance imaging and surgical treatment...
February 2018: Orthopaedic Journal of Sports Medicine
George L Vestermark, Bryce A Van Doren, Patrick M Connor, James E Fleischli, Dana P Piasecki, Nady Hamid
BACKGROUND: The prevalence and severity of concomitant rotator cuff pathology in the setting of proximal biceps tendon ruptures are poorly understood. Concomitant rotator cuff disease may have important implications in the prognosis and natural history of this shoulder condition. Therefore, an observational cohort of patients with an acute rupture of the long head of the biceps tendon (LHBT) was evaluated to determine the prevalence and severity of concomitant rotator cuff disease. METHODS: Thirty consecutive patients diagnosed with acute proximal biceps tendon rupture were prospectively enrolled...
February 22, 2018: Journal of Shoulder and Elbow Surgery
Brian C Lau, Daria Motamedi, Anthony Luke
OBJECTIVE: Musculoskeletal ultrasound imaging is increasingly being used for static and dynamic imaging of tendons, muscles, ligaments, and bones. New, hand-held, pocket-sized ultrasounds are more portable and affordable. The purpose of this study was to evaluate the feasibility of pocket-sized ultrasound to diagnose shoulder pathology. DESIGN: Prospective cohort study. SETTING: Tertiary Care Hospital. METHODS: Ten consecutive patients (mean age 54; range 42-68 years) referred for a shoulder ultrasound for evaluation of shoulder pain were recruited...
February 14, 2018: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Thomas Amouyel, Yves-Pierre Le Moulec, Nicolas Tarissi, Mo Saffarini, Olivier Courage
Arthroscopic repair of the long head of the biceps (LHB) is performed to treat various biceps pathologies yet the choice between tenotomy or tenodesis remains controversial. Although tenotomy is simpler and quicker, tenodesis results in fewer complications, and there are several techniques available using various fixation devices and sites. This Technical Note describes an all-arthroscopic, suprapectoral tenodesis technique using a bioresorbable interference screw, without motorized devices to create the humeral tunnel in the bicipital groove...
October 2017: Arthroscopy Techniques
Ivan R B Godoy, Edgar L Martinez-Salazar, F Joseph Simeone, Miriam A Bredella, William E Palmer, Martin Torriani
OBJECTIVE: To evaluate the significance of biceps tendon (BT) displacement and peri-bicipital hematoma on MRI in subjects with pectoralis major (PM) tears. We hypothesized that these features might be associated with tear severity at surgery. MATERIALS AND METHODS: We retrospectively identified MRI cases with PM injury and reviewed clinical, imaging, and surgical records. MR images were reviewed independently by two musculoskeletal radiologists to determine anterior displacement of BT (BT-disp, in mm) and the presence of triangular-shaped peri-bicipital hematoma...
February 9, 2018: Skeletal Radiology
Kyle E Fleck, Larry D Field
Pathologic changes to the biceps tendon including subluxation are frequently encountered in patients with subscapularis tears. Operatively managing these combined lesions can be difficult depending on the status of the subscapularis tendon and the degree of biceps medialization. The presented technique is an effective and relatively simple method that simultaneously and efficiently provides for secure tenodesis of the biceps and fixation of subscapularis tendon detachment.
October 2017: Arthroscopy Techniques
Nicholas I Kennedy, George Sanchez, Sandeep Mannava, Márcio B Ferrari, Salvatore J Frangiamore, Matthew T Provencher
With a range of tear characteristics such as chronicity, degree of fatty atrophy, and number of tendons involved as well as varying patient-specific characteristics including age, injury mechanism, and expectations after treatment to consider, proper and successful treatment of a rotator cuff tear is multifactorial and, consequently, challenging. Although conservative management of a rotator cuff tear may be successful, a more severe tear with involvement of more tendons may warrant surgical intervention. Furthermore, additional pathology including biceps tendinopathy may result in greater patient morbidity and an even more complex treatment decision-making process and surgical technique...
October 2017: Arthroscopy Techniques
Paweł Reichert, Aleksandra Królikowska, Jarosław Witkowski, Łukasz Szuba, Andrzej Czamara
BACKGROUND Although iatrogenic posterior interosseous nerve (PIN) palsy is an uncommon complication of ruptured distal biceps brachii tendon surgical anatomical reinsertion, it is the most severe complication leading to functional limitation. The present study investigated possible types of PIN palsy as a postoperative complication of anatomical distal biceps tendon reinsertion, and aimed to clinically assess patients at 2 years after its surgical treatment. MATERIAL AND METHODS The studied sample comprised 7 male patients diagnosed with an iatrogenic PIN palsies after anatomical reinsertion of the distal biceps tendon, who were referred to the reference center for management of a peripheral nervous system injury...
February 7, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Christopher M Gibbs, Alexander D Ginsburg, Thomas J Wilson, Nirusha Lachman, Mario Hevesi, Robert J Spinner, Aaron J Krych
INTRODUCTION: A "perineal" branch of the sciatic nerve has been visualized during surgery, but there is currently no description of this nerve branch in the literature. Our study investigates the presence and frequency of occurrence of perineal innervation by the sciatic nerve and characterizes its anatomy in the posterior thigh. MATERIALS AND METHODS: Fifteen cadavers were obtained for dissection. Descriptive results were recorded.Statistical analysis was performed and analyzed statistically...
February 7, 2018: Clinical Anatomy
Jan Zabrzyński, Łukasz Paczesny, Agnieszka Zabrzyńska, Dariusz Grzanka, Łukasz Łapaj
Disorders of the long head of the biceps tendon (LHBT) are a common source of shoulder pain and disability. This tendon can be well visualized using ultrasonography; however, little is known if such examination allows clinicians to predict pathological changes of the tendon structure. In the study described below, we compare preoperative sonographic findings with the data from shoulder arthroscopy and microscopic examination of the excised tendon fragments in 19 consecutive patients with LHB tendinopathy and clinical suspicion of its instability...
February 5, 2018: Folia Morphologica (Warsz)
Christopher Arena, Aman Dhawan
The long head of the biceps (LHB) tendon is a potential source of shoulder pain encountered by orthopaedic surgeons. A multitude of approaches to addressing LHB tendinopathy have been described. These include various surgical techniques such as tenodesis versus tenotomy, an arthroscopic versus an open approach, and differing methods of tenodesis fixation. Our preferred approach to addressing LHB tendinopathy is through a mini-open approach using a double-loaded 4.5-mm suture anchor. This Technical Note with accompanying video describes our technique for performing this procedure, as well as supporting clinical evidence and technical pearls...
October 2017: Arthroscopy Techniques
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