• Clinics in Shoulder and Elbow
• /
• v.16 no.1
• /
• pp.47-52
• /
• 2013

Lesions of the long head biceps tendon pulley are frequent causes of shoulder dysfunction and pain. These lesions cause instability of the long head of the biceps tendon (LHB), and intra-articular tear of the subscapularis and the supraspinatus tendon might result from them. The arthroscopic repair of these lesions has not gained widespread acceptance as an effective procedure. Predictable results can be obtained by treating these lesions more definitively with tenotomy or tenodesis. The purpose of this article is to review the anatomy and properties of the LHB pulley and to provide treatment strategies for alleviating pulley lesions.

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.11 no.1
• /
• pp.24-29
• /
• 2012

Purpose: To evaluate follow-up after the clinical results of arthroscopic assisted tenodesis of the proximal biceps tendon using an interference screw. Materials and Methods: We reviewed 30 cases of patients receiving tenodesis of the proximal biceps tendon between January, 2008 and January, 2010 who treated with arthroscope. The results were judged by VAS, ASES, tenderness in the biceps groove, fixation failure and the degree of deformity. Results: VAS, ASES scores increased by a statistically significant during the final observation in all patients than before surgery (p<0.05). For those with rotator cuff tear had low ASES results (p<0.05), respectively. But, tenderness in the biceps groove was 17% (5 cases), pepeye deformity and incresead BAD (biceps apex distance) were 10% (3 cases). Conclusion: Arthroscopic tenodesis of the proximal biceps tendon using an interference screw to patients with proximal lesion in their biceps tendon, can achieve good results, but it is possible to groove tenderness and popeye deformity.

• Clinics in Shoulder and Elbow
• /
• v.14 no.1
• /
• pp.13-19
• /
• 2011

Purpose: Not much is known about the obvious relationship between posteroinferior rotator cuff tear and biceps lesion. The purpose of this study is to analyze the effect of posteroinferior rotator cuff tear on a biceps lesions by comparing the rotator cuff tear and biceps lesions with the number of cuff tears and the degree of degeneration of the rotator cuff. Materials and Methods: 65 patients who underwent surgery for a posteroinferior rotator cuff tear from 2002 to 2009 were included as subjects. The study determined the factors (the number of cuff tears and the degree of degeneration as assessed by MRI) that affected biceps lesions and the kinematic stability of the rotator cuff. Results: Biceps lesion was noted 11 patients among the 51 patients with supraspinatus tendon tears and in 8 patients among the 14 patients with supraspinatus, infraspinatus or teres minor tendon tears, and there was a statistically significant difference between those two groups (p=0.0095). The number of cuff tears was proportional to biceps lesion with statistical significance (p=0.0095). Among the biceps lesions, SLAP II lesion showed a statistically different distribution according to the number of cuff tears (p=0.0073). The degeneration factors (Goutallier's classification and the tangent sign) had no correlations with biceps lesion. Conclusion: Posterosuperior cuff tear may affect biceps lesion. Especially, the number of cuff tears has a close relationship, but the degenerative indicators have no relationship with biceps lesion.

• 대한관절경학회:학술대회논문집
• /
• 2009.10a
• /
• pp.183-187
• /
• 2009

Labral lesions and anatomic variants have been studied by several authors in the last decade. Buford complex and sublabral recess and foramen are most common variants. Their recognition is important in order to distinguish them from superior and anterior labral tear. We report rare normal variant of biceps anchor and superior labrum that was observed during arthroscopic surgery for SLAP lesion.

• Clinics in Shoulder and Elbow
• /
• v.12 no.2
• /
• pp.245-249
• /
• 2009

Purpose: Labral lesions and its anatomic variants have been studied by several authors in the last decade. Buford complex and sublabral recess are most common variants. Their recognition is important in order to distinguish them from superior and anterior labral tear. Materials and Methods: We report one case of a 19-year-old female who was mistaken SLAP lesion for normal variant and was treated with arthroscopic surgery. Results: The arthroscopic finding shows rare normal variant of biceps anchor and superior labrum. The biceps long head tendon was inserted at superior labrum and supraspinatus tendon area. This finding was mistaken to SLAP lesion. Conclusion: We report rare normal variant of biceps anchor and superior labrum that was observed during arthroscopic surgery for SLAP lesion.

• Clinics in Shoulder and Elbow
• /
• v.13 no.1
• /
• pp.64-71
• /
• 2010

Purpose: To evaluate pathologic patterns and outcomes of treatment of a biceps tendon lesion associated with a rotator cuff tear. Materials and Methods: We reviewed 92 patients (i) who underwent surgery for a cuff tear, (ii) for whom the biceps lesion could be observed retrospectively, and (iii) had a minimum follow-up of 2 years. The pathology of biceps tendon was classified into 4 types: tenosynovitis, fraying or hypertrophy, tear, and instability. All but the 4 with massive cuff tears were repaired. The biceps lesions were treated with debridement in 30, tenotomy in 10, tenodesis in 8, and recentering in 4. UCLA scoring was used for clinical results. Results: Seventy patients had a biceps lesion, 19 tenosynovitis, 22 fraying or hypertrophy, 21 a tear, and 8 instability. A biceps lesion was observed in 63% of cases of cuff tears below the medium size, and in 88% of cases with cuff tears above the large size. UCLA scores according to the pathology of the biceps lesion were 29.6 in the absence of a biceps lesion, and 28.3 in its presence. UCLA scores in patients with tenotomy or tenodesis for associated biceps tendon lesions were 28.2. Conclusion: There is a greater incidence and severity of a biceps lesion with a larger cuff tear. Therefore, the cause of a biceps lesion might be related to the cause of the cuff tear. Among the several options of treatment for biceps lesion, tenotomy or tenodesis may be particularly effective in providing pain relief.

• Journal of the Korean Orthopaedic Association
• /
• v.55 no.2
• /
• pp.135-142
• /
• 2020

Purpose: This paper presents the long term follow-up results of arthroscopic partial repair for massive irreparable rotator cuff tears using a biceps long head auto graft. Materials and Methods: Forty-one patients with massive irreparable rotator cuff tear, who underwent arthroscopic repair, were reviewed retrospectively. Patients who underwent arthroscopic partial repair using a biceps long head auto graft were assigned to group 1, and patients in group 2 underwent arthroscopic partial repair alone. Patients with a less than 50% partial tear of the long head biceps tendon were included in this study. The clinical scores were measured using a visual analogue pain scale (VAS) for pain, range of motion (ROM), The University of California, Los Angeles shoulder score (UCLA), American Shoulder and Elbow Surgeons Shoulder Score (ASES), and Korean Shoulder Scoring System (KSS) scores preoperatively and at the final follow-up. The acromiohumeral interval (AHI) was measured using plain radiographs taken preoperatively and at the final follow-up, and re-tear was evaluated using postoperative ultrasound or magnetic resonance imaging at the last follow-up. Results: The mean age of the patients was 62.1±12.7 years, and the mean follow-up period was 90.3±16.8 months. No significant differences in the VAS and ROM (forward flexion, external rotation, internal rotation) were found between the two groups (p=0.179, p=0.129, p=0.098, p=0.155, respectively). The UCLA (p=0.041), ASES (p=0.023), and KSS (p=0.019) scores showed functional improvements in group 1 compared to group 2. At the last follow-up, the measured AHI values were 9.46±0.41 mm and 6.86±0.64 mm in group 1 and 2, respectively (p=0.032). Re-tear was observed in six out of 21 cases (28.6%) in group 1 and nine out of 20 cases (45.0%) in group 2; the retear rate was significantly lower in group 1 than in group 2 (p=0.011). Conclusion: Arthroscopic partial repair for a massive irreparable rotator cuff tear using a biceps long head auto graft has significant clinical usefulness in functional recovery and decreases the re-tear rates after surgery than arthroscopic partial repair alone, showing favorable results after a long-term follow-up.

• Clinics in Shoulder and Elbow
• /
• v.16 no.2
• /
• pp.94-99
• /
• 2013

Purpose: The purpose of this study is to evaluate the clinical results of arthroscopic biceps long head suprapectoral tenodesis using an interference screw. Materials and Methods: We reviewed the cases of 30 patients who underwent arthroscopic biceps long head suprapectoral tenodesis using an interference screw between January 2008 and January 2010. The minimum follow up period was one year. Twenty patients had rotator cuff tears. The results were analyzed by VAS, ASES, tenderness in the bicipital groove, fixation failure, and the degree of deformity. Results: VAS, ASES scores showed a statistically significant increase during the final observation in all patients, compared with those before surgery. However, five patients (17%) had anterior shoulder pain and tenderness in the biceps groove, and three patients (10%) had Popeye deformity. Better results were achieved in patients without rotator cuff tear than in patients with rotator cuff tear (p<0.05). Conclusion: Arthroscopic biceps long head tenodesis above the pectoralis major using an interference screw in patients with a pathologic lesion of the proximal biceps tendon showed good results at the last follow up. However, further study for tenderness in the biceps groove in 17% of patients is needed.

• Clinics in Shoulder and Elbow
• /
• v.13 no.1
• /
• pp.7-13
• /
• 2010

Purpose: Our purpose was to retrospectively analyze clinical results of subpectoral tenodesis of the proximal biceps tendon using an interference screw. Materials and Methods: We reviewed 23 cases of patients receiving tenodesis of the proximal biceps tendon between January 2008 and January 2009 for whom we had follow-up data for at least 1 year. Twenty-three cases were operated on using subpectoral tenodesis; 16 of these cases had a rotator cuff tear. The results were judged using a visual analog scale (VAS), ASES, tenderness on the biceps groove, fixation failure and the degree of deformity (BAD). Results: VAS and ASES scores were significantly improved in all patients by the time of the final observation. There were no significant complications or fixation failures. The patients without a tear of the rotator cuff had a better result than patients with a tear of the rotator cuff, but the difference between the two groups was not significant (p>0.05). Conclusion: In patients with pathology of the long head of the biceps brachii, benefits of subpectoral interference screw tenodesis include pain relief, maintenance of functional biceps, muscle strength, and cosmesis. Subpectoral biceps tenodesis using interference screw fixation appears to be a promising, reproducible, reliable technique for addressing anterior shoulder pain related to pathology of the long head of the biceps brachii.

• Journal of the Korean Society of Radiology
• /
• v.85 no.1
• /
• pp.171-183
• /
• 2024

Purpose This study aimed to investigate which indirect parameters on preoperative MRI were the principal predictors of subscapularis tendon tears (STTs) requiring surgical repair. Materials and Methods Preoperative MRI scans of 86 patients were retrospectively reviewed for visual assessment of the STT, pathology of the long head of the biceps tendon (LHBT), posterior decentering (PD) of the humeral head, humeral rotation, fatty degeneration, and subscapularis muscle atrophy. To evaluate atrophy, visual grading using the anatomical line connecting the coracoid tip to the glenoid base, designated as the base-to-tip line (BTL), and thickness measurements were performed in the en-face view. Results Arthroscopically, 31 patients (36%) exhibited Lafosse type III or IV STT and underwent surgical repair. LHBT pathology (p = 0.002), PD of the humeral head (p = 0.012), fatty degeneration (p < 0.001), and BTL grade (p = 0.003) significantly correlated with STT. In the multivariate analysis, PD of the humeral head (p = 0.011, odds ratio [OR] = 5.14) and fatty degeneration (p = 0.046, OR = 2.81) were independent predictors of STT. Conclusion PD of the humeral head and fatty degeneration of the subscapularis can help to diagnose clinically significant STT. Interpretation of these findings may contribute to the planning of an optimal surgical strategy.