Effects of Biceps Tenotomy on The Shoulder Joint in the Treatment of Slap Lesions

Year 2025, Volume: 20 Issue: 3, 179 - 185

Caner Poyraz , Vahit Yıldız

https://doi.org/10.17517/ksutfd.1570649

Abstract

Objective: This study aimed to investigate the radiologic and clinical changes in the shoulder joint after biceps tenotomy for isolated SLAP (Superior Labrum Anterior to Posterior) lesions.
Material and Methods: A total of 380 patients who underwent shoulder arthroscopy for SLAP lesions between September 2015 and September 2019 in our center were retrospectively analyzed. The study included 44 patients who met the inclusion criteria (isolated SLAP lesion, biceps tenotomy, no shoulder instability, no advanced shoulder arthrosis, no additional shoulder pathology, follow-up period longer than 1 year). Post operative and pre-operative values of the patients were compared with clinical and radiologic measurements. In clinical evaluation; UCLA, Constant, VAS, DASH scoring system and muscle strength were compared. In radiologic evaluation; Superior Humeral Migration, Coracohumeral Distance, Acromiohumeral Distance, Critical Shoulder Angle, Acromial Index were compared.
Results: Among the 44 patients included in the study, 18 were female and 26 were male. The mean age of the patients was 51 years and the mean follow-up period was 32.2 months. In the preoperative measurements of the patients, Coracohumeral Distance: 11.5 ± 2.4 mm, Superior Migration of the Humeral Head: 3.4 ± 1.0 mm. In the postoperative group measurements, Coracohumeral Distance: 8.4 ± 1.4 mm, Superior Migration of the Humeral Head: 4.5 ± 1.3 mm. When these values were compared, the changes in the SHY and KH distance values were statistically significant (p=0.031, p=0.012). Significant improvements were observed in all functional measurements and scoring systems within the scope of clinical evaluations.
Conclusion: Biceps tenotomy in the treatment of isolated SLAP lesions resulted in anterior and superior translation of the humerus radiologically. According to clinical evaluations, tenotomy contributes to pain relief and improved function in these patients.

Keywords

SLAP lesion , Biceps Pathology , Superior Humeral Orientation , Coracohumeral Distance , Biceps Tenotomy.

Slap Lezyonlarına Uygulanan Biceps Tenotomisinin Omuz Eklemine Etkileri

Abstract

Amaç: Bu çalışmada izole SLAP (Superior Labrum Anterior To Posterior) lezyonlarında biseps tenotomisi sonrası omuz eklemindeki radyolojik ve klinik değişikliklerin araştırılması amaçlandı.
Gereç ve Yöntemler: Eylül 2015 ile Eylül 2019 tarihleri arasında merkezimizde SLAP lezyonları için omuz artroskopisi yapılan toplam 380 hasta retrospektif olarak analiz edildi. Çalışmaya dahil edilme kriterlerini karşılayan 44 hasta dahil edildi (izole SLAP lezyonu, biseps tenotomisi, omuz instabilitesi yok, ileri omuz artrozu yok, ek omuz patolojisi yok, takip süresi 1 yıldan uzun). Hastaların ameliyat öncesi ve sonrası değerleri klinik ve radyolojik ölçümlerle karşılaştırıldı. Klinik değerlendirmede; UCLA, Constant, VAS, DASH skorlama sistemi ve kas gücü karşılaştırıldı. Radyolojik değerlendirmede; Superior Humeral Migrasyon, Korakohumeral Mesafe, Akromiohumeral Mesafe, Kritik Omuz Açısı, Akromiyal İndeks karşılaştırıldı.
Bulgular: Çalışmaya dahil edilen 44 hastanın 18'i kadın, 26'sı erkekti. Hastaların ortalama yaşı 51 ve ortalama takip süresi 32,2 aydı. Hastaların ameliyat öncesi ölçümlerinde Korakohumeral Mesafe: 11,5 ± 2,4 mm, Humerus Başı Superior Migrasyonu: 3,4 ± 1,0 mm idi. Ameliyat sonrası grup ölçümlerinde Korakohumeral Mesafe: 8,4 ± 1,4 mm, Humerus Başı Superior Migrasyonu: 4,5 ± 1,3 mm. Bu değerler karşılaştırıldığında, SHY ve KH mesafesi değerlerindeki değişiklikler istatistiksel olarak anlamlıydı (p=0,031, p=0,012). Klinik değerlendirmeler kapsamındaki tüm fonksiyonel ölçümlerde ve skorlama sistemlerinde istatistiksel olarak anlamlı iyileşmeler gözlendi.
Sonuç: İzole SLAP lezyonlarının tedavisinde biseps tenotomisi, radyolojik olarak humerusun anterior ve superior translasyonu ile sonuçlandı. Klinik değerlendirmelere göre, tenotomi bu hastalarda ağrının giderilmesine ve fonksiyonun iyileşmesine katkıda bulunmaktadır.

Keywords

SLAP lezyonu , Biceps Patolojisi , Superior Humeral Yönelim , Korakohumeral Mesafe , Biceps Tenotomisi.

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