Rotator Kılıf Yırtığına Eşlik Eden Biseps Tendon Patolojilerinde, Biseps Kasının Uzun Başına Yapılan Tenodez ve Tenotomi Sonuçlarının Karşılaştırılması

Abstract

Objectives: Pathologies of long head of biceps (LHB) tendon may be seen in rotator cuff lesions. Treatment of this tendon has been matter of discussion. Conservative treatment is advised for partial LHB tendon tears with mild and moderate pain. In partial LHB tendon tears with severe pain, biceps pulley lesions and superior labrum anterior posterior lesions, surgical treatment is advised. The matter of which surgical option choose (repair, tenotomy, tenodesis) is still controversial. The aim of this study is to discuss about the clinical results of the patients who underwent LHB tendon tenotomy or mini open subpectoral tenodesis after arthroscopic rotator cuff tear. Materials and Methods: The patients whom had arthroscopic tenotomy and subpectoral tenodesis were evaluated with VAS (Visual Analogue Scale), ASES (American Shoulder and Elbow Surgeons Shoulder Score) and Constant score, preoperatively and at the last follow-up and recommendations for the surgery to be applied were given. Results: Patients were evaluated with VAS, ASES and Constant Scores in the preoperative and final controls. There was no statistically significant difference between the two groups (p>0.05). Conclusion: Because of the simplicity of surgical technique and lower morbidity, we believe that the tenotomy option may be considered if the long head of the biceps muscle is planned for surgery in patients over 55 years of age.

Keywords

• Rotator Cuff
• Long Head of Biceps
• Tenotomy
• Tenodesis

References

1. 1. Friedman DJ, Dunn JC, Higgins LD, et al. Proximal biceps tendon: injuries and management. Sports Med Arthrosc Rev. 2008;16:162-169.
2. 2. Kilicoglu O, Koyuncu O, Demirhan M. et al. Time-dependent changes in failure loads of 3 biceps tenodesis techniques: in vivo study in a sheep model. Am J Sports Med. 2005;33:1536-1544.
3. 3. Ozalay M, Akpinar S, Karaeminogullari O, et al. (2005) Mechanical strength of four different biceps tenodesis techniques. Arthroscopy. 2005;21:992-998.
4. 4. Kannus P, Józsa L. Histopathological changes preceding spontaneous rupture of a tendon. A controlled study of 891 patients. A controlled study of 891 patients. J Bone Joint Surg Am. 1991;73:1507-1525.
5. 5. Gill TJ, McIrvin E, Mair SD, et al. Results of biceps tenotomy for treatment of pathology of the long head of the biceps brachii. J Shoulder Elbow Surg. 2001;10:247-249.
6. 6. Hsu AR, Ghodadra NS, Provencher MT, et al. Biceps tenotomy versus tenodesis: a review of clinical outcomesand biomechanical results. J Shoulder Elbow Surg. 2011;20:326-332.
7. 7. Kelly AM, Drakos MC, Fealy S, et al. Arthroscopic release of the long head of the biceps tendon: functional outcome and clinical results. Am J Sports Med. 2005;33:208-213.
8. 8. Mazzocca AD, Bicos J, Santangelo S, et al. The biomechanical evaluation of four fixation techniques for proximal biceps tenodesis. Arthroscopy. 2005;21:1296-1306.

9. 9. K. Varantola, V. Launis, M. Helin, et al. Responsible Conduct of Research and Procedures for Handling Allegations of Misconduct in Finland, Finnish Advisory Board on Research Integrity, Helsinki, 2013.
10. 10. Boileau P, Baqué F, Valerio L, et al. Isolated arthroscopic biceps tenotomy or tenodesis improves symptoms in patients with massive irreparable rotator cuff tears. J Bone Joint Surg Am. 2007;89:747-757.
11. 11. Ahmad CS, DiSipio C, Lester J, et al. Factors affecting dropped biceps deformity after tenotomy of the long head of the biceps tendon. Arthroscopy. 2007;23:537-541.
12. 12. Klepps S, Hazrati Y, Flatow E. Arthroscopic biceps tenodesis. Arthroscopy. 2002;18:1040-1045.
13. 13. Randelli P, Arrigoni P, Cabitza F, et al. Current practice in shoulder pathology: results of a web-basedsurvey among a community of 1,084 orthopedic surgeons. Knee Surg Sports Traumatol Arthrosc. 2012;20:803-815.