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Biceps tenodesis

William Rossy, George Sanchez, Anthony Sanchez, Matthew T Provencher
CONTEXT: Given the notable physical demands placed on active members of the military, comprehension of recent trends in management and outcomes of superior labral anterior-posterior (SLAP) tears in this patient population is critical for successful treatment. EVIDENCE ACQUISITION: Electronic databases, including PubMed, MEDLINE, and Embase, were reviewed for the years 1985 through 2016. STUDY DESIGN: Database review. LEVEL OF EVIDENCE: Level 5...
October 7, 2016: Sports Health
Keith T Corpus, Samuel A Taylor, Stephen J O'Brien, Lawrence V Gulotta
BACKGROUND: Traditional intra-articular arthroscopic repair techniques for massive anterosuperior rotator cuff tears are technically demanding and necessitate sacrifice of the rotator interval to enable visualization. An interval slide allows mobilization through release of the medial aspect of the rotator interval, while leaving the lateral, bridging fibers intact. QUESTIONS/PURPOSES: The purpose of this study was to report a novel, arthroscopic, open-equivalent technique using the subdeltoid space to address these tears along with early clinical results...
October 2016: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Jamison M Green, Mark H Getelman, Stephen J Snyder, Joseph P Burns
PURPOSE: To compare patient-reported outcomes and healing rates after open subpectoral and all-arthroscopic suprapectoral biceps tenodesis without the use of interference screws in patients with more than 2 years of follow-up. METHODS: Patients with at least 2 years of follow-up who underwent open subpectoral biceps tenodesis or all-arthroscopic suprapectoral biceps tenodesis without concomitant rotator cuff repair, labral repair, or Mumford procedure were considered for enrollment in the study...
September 19, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Saad M AlQahtani, Ryan T Bicknell
Lesions of the proximal long head of the biceps tendon (LHB) have been considered as a major cause of shoulder pain and dysfunction. The role of the LHB in causing pain has been a source of controversy for many years, and extensive literature is available discussing anatomy, function, pathology, and most importantly appropriate treatment. Despite this, there is a lack of consensus in the literature regarding the management of biceps-related pathology. Biceps tenotomy and tenodesis are common surgical treatment options when dealing with LHB-related pathology...
September 6, 2016: Current Reviews in Musculoskeletal Medicine
Alexander B Christ, Elizabeth B Gausden, Stephen J Warner, Andrew M Nellestein, Ryan Thacher, Dean G Lorich
Antegrade intramedullary nails are an established, effective method of fixation for humeral shaft fractures. One significant limitation of this technique is chronic post-operative shoulder pain, which is likely related to the standard approach that involves splitting the rotator cuff to gain access to the nail starting point. Furthermore, mounting evidence suggests that both the intra-articular portion of the biceps tendon and the extra-articular portion in the bicipital groove can scar down after trauma, causing pain and limiting shoulder range-of-motion...
August 23, 2016: Journal of Orthopaedic Trauma
Derek Friedrich Petrus van Deurzen, Vanessa Antoinet Bernice Scholtes, Nienke Willemien Willigenburg, Navin Gurnani, Lukas Pieter Eduard Verweij, Michel Pieter Jozef van den Bekerom
BACKGROUND: Optimal treatment of the diseased long head of the biceps (LHB) tendon during rotator cuff repair remains a topic of debate: tenotomy or tenodesis. A recent meta analysis revealed no difference in strength or functional outcome between treatments. The included studies varied in methodological quality, and only two were randomized controlled trials (RCTs). As strong evidence in favor of either tenotomy or tenodesis is still lacking, we designed this randomized controlled trial to compare functional outcomes after tenotomy and tenodesis when performed in adjunct to arthroscopic rotator cuff repair...
2016: BMC Musculoskeletal Disorders
D J De Villiers, B Loh, M Tacey, P Keith
PURPOSE: To assess the maximum and end torque of a fourth-generation composite humerus model with no screw inserted or with a screw inserted in the distal (subpectoral) position or proximal (suprapectoral) position. METHODS: 24 large-size, fourth-generation composite humeri were randomised to the control (n=8), proximal (n=8), or distal (n=8) group. For the latter 2 groups, an 8-mm-head interference screw (7x25 mm) was inserted at 1 cm proximal and 1 cm distal to the superior aspect of the insertion of the pectoralis major tendon, respectively...
August 2016: Journal of Orthopaedic Surgery
James R Meadows, Matthew M Diesselhorst, Jonathan T Finnoff, Britta L Swanson, Kyle E Swanson
Use of a cortical button for proximal biceps tenodesis has demonstrated strength comparable to that of other types of fixation in biomechanical models, but few studies have evaluated the clinical outcome of such fixation. In the study reported here, 18 patients who underwent open subpectoral biceps tenodesis with a bicortical button were assessed, at minimum 12-month follow-up, with the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, a pain scale, physical examination, biceps supination strength testing, and ultrasonographic evaluation (to determine tenodesis integrity and proximity of the button to the axillary nerve)...
July 2016: American Journal of Orthopedics
David E Hartigan, Matthew C Beran, James E Fleischli, Donald F D'Alessandro, Naiquan Nigel Zheng
The percutaneous intra-articular transtendon (PITT) technique has recently been shown to have results comparable to those of more accepted techniques. Its mode of failure was secondary to the suture pulling through the tendon substance. A modification was made whereby the tendon is locked within the suture configuration in an attempt to avoid pullout. We compared this new technique with a well-accepted technique of all-arthroscopic interference screw. In each of 8 pairs of cadaveric shoulders (mean age, 55 years; range, 51-59 years), one shoulder was randomized to be treated with either modified PITT or interference screw (Biceptor; Smith & Nephew) biceps tenodesis, and the other shoulder was treated with the other technique...
July 2016: American Journal of Orthopedics
Kyle R Duchman, David E DeMik, Bastian Uribe, Brian R Wolf, Matthew Bollier
BACKGROUND: The proximal aspect of the long head of the biceps brachii (LHB) is a frequent source of anterior shoulder pain. Multiple techniques for LHB tenodesis have been described. However, comparative outcomes are lacking. The present study aims to compare functional results, patient reported outcomes, complications, and clinical failures for patients undergoing open versus arthroscopic LHB tenodesis. METHODS: All patients who underwent open or arthroscopic LHB tenodesis from 2009-2012 at a single institution were identified...
2016: Iowa Orthopaedic Journal
Roy Gigi, Oleg Dolkart, Zachary T Sharfman, Yariv Goldstein, Tamar Brosh, Ehud Rath, Eran Maman, Ofir Chechik
BACKGROUND: Several techniques and procedures have been described to treat long head of the biceps pathology; however, tenodesis and tenotomy are the 2 most common procedures performed. This study evaluated the initial fixation strength of the biceps tenodesis triple loop suture (TLS) technique and compared it with that of the simple suture technique (SST). METHODS: Twenty fresh frozen cadaveric human shoulders (humeral head and neck with attached biceps tendons) were harvested...
August 5, 2016: Journal of Shoulder and Elbow Surgery
Justin J Mitchell, Marilee P Horan, Joshua A Greenspoon, Travis J Menge, Dimitri S Tahal, Peter J Millett
BACKGROUND: There are little data on midterm outcomes after the arthroscopic management of glenohumeral osteoarthritis (GHOA) in young active patients. PURPOSE: To report outcomes and survivorship for the comprehensive arthroscopic management (CAM) procedure for the treatment of GHOA at a minimum of 5 years postoperatively. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: The CAM procedure was performed on a consecutive series of 46 patients (49 shoulders) with advanced GHOA who met criteria for shoulder arthroplasty but instead opted for a joint-preserving, arthroscopic surgical option...
August 5, 2016: American Journal of Sports Medicine
J Pogorzelski, K Beitzel, A B Imhoff, P Millett, S Braun
OBJECTIVE: Therapy of intraarticular lesions and elimination of structural risk factors for those suffering from clinical manifest anterosuperiorer impingement (ASI) of the shoulder. This includes as a maximum version the arthroscopic repair of supraspinatus (SST) and subscapularis tendon (SCT) tears with subsequent subpectoral tenodesis of the long head of the biceps tendon (LBT) and arthroscopic coracoplasty. INDICATIONS: Clinical manifest anterosuperiorer impingement of the shoulder with anterior shoulder pain, failed conservative treatment and clear intraarticular damage in radiological imaging...
August 2, 2016: Operative Orthopädie und Traumatologie
M Beirer, G H Sandmann, A B Imhoff, S Buchmann
OBJECTIVE: To restore the physiologic anterior and posterior capsular volume to achieve an anatomic central contact point of the glenohumeral articulation and treatment of concomitant glenohumeral injuries due to posterosuperior impingement (PSI). INDICATIONS: Plateauing of clinical improvement despite adequate nonsurgical treatment (for at least 6-12 months). CONTRAINDICATIONS: General contraindications for elective arthroscopic surgery...
July 28, 2016: Operative Orthopädie und Traumatologie
Micah Lissy, Amanda Esquivel, Allison Cracchiolo, Stephen Lemos
BACKGROUND: Biceps tenotomy and biceps tenodesis are the primary methods of treating biceps pathology. This study describes a new technique of tenotomy with the goal of autotenodesis to give the biceps a higher load to failure and decreased chance of a Popeye deformity. PURPOSE: The purpose of this study was to evaluate the strength of the "biceps knot", which is an outlet tenodesis of the biceps tendon and compare the biomechanical properties of this technique to tenotomy...
September 2016: Journal of Orthopaedics
S Uschok, S Herrmann, S Pauly, C Perka, S Greiner
PURPOSE AND HYPOTHESIS: This study evaluates the functional and cosmetic results following fixation of the long head of the biceps (LHB) tendon at the antero-medial footprint anchor of a rotator cuff reconstruction, using the "lasso-loop" technique. METHODS: 39 patients with a mean age of 62 years with a rotator cuff tear and associated lesion of the LHB tendon were included in this study. Besides rotator cuff repair in an arthroscopic anchor technique, all patients received additional LHB tenodeses using the lasso-loop technique...
September 2016: Archives of Orthopaedic and Trauma Surgery
Christopher L Camp, Pramod B Voleti, Keith T Corpus, Joshua S Dines
Patients who experience distal biceps tendon avulsions generally benefit from surgical intervention. Compared with nonoperative treatment, surgery has shown improved muscle endurance as well as increased flexion and supination strength. Although a number of surgical techniques exist, repair of the distal biceps through a single incision is gaining popularity. This may be due in part to patient preference and emerging technologies such as cortical button fixation, suture anchors, and intraosseous screws. In this report, we present a simple technique for anatomically repairing distal biceps injuries using an intramedullary tenodesis button...
April 2016: Arthroscopy Techniques
Joshua A Greenspoon, Maximilian Petri, Peter J Millett
The management of massive rotator cuff tears remains a challenge for physicians, with failure rates being higher when compared with smaller tears. Many surgical treatment options exist including debridement with biceps tenodesis, complete repair, partial repair, repair with augmentation devices, superior capsule reconstruction, tendon transfer, and reverse total shoulder arthroplasty. The purpose of this article is to describe our preferred surgical technique for a complete arthroscopic repair using an extended linked, knotless, double-row construct...
February 2016: Arthroscopy Techniques
Balazs Galdi, Daniel L Southren, Eugene W Brabston, Charles A Popkin, Charles M Jobin, William N Levine, Christopher S Ahmad
PURPOSE: To evaluate what factors are important in the patients' preference and their perception of a successful surgical outcome. METHODS: A biceps-specific questionnaire was developed using a series of questions assessing current symptoms, previous knowledge of biceps tendon surgery, surgical outcome priorities, and patient demographics and administered to 100 patients with proximal biceps pathology after approval by the Institutional Review Board. The patients were asked which surgery they would prefer...
June 16, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Rueben Nair, Cynthia A Kahlenberg, Ronak M Patel, Michael Knesek, Michael A Terry
Biceps tenodesis is a common treatment for pathology of the long head of the biceps tendon. Several authors have described various arthroscopic and open techniques for biceps tenodesis. Open techniques have been associated with complications such as wound infection and nerve injury. Previously described arthroscopic techniques have placed the tenodesis site within the bicipital groove, which may lead to persistent pain. We describe an all-arthroscopic suprapectoral biceps tenodesis technique that places the tenodesis site distal to the bicipital groove...
December 2015: Arthroscopy Techniques
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