• Clinics in Shoulder and Elbow
• /
• v.1 no.1
• /
• pp.78-82
• /
• 1998

The following will describe a method of evaluating the SLAP lesion in the recurrent anterior dislocation of the shoulder. We have named it the biceps load test. The biceps load test is performed with the patient in the supine position and the arm to be examined is abducted 90/sup°/, and the forearm is in the supinated position. First, the anterior apprehension test is performed. When the patient become apprehensive, the patient is allowed active flexion of the elbow, while the examiner resists elbow flexion. If the apprehension is relieved or diminished, the test is negative. If aggravated or unchanged, the test is positive. A prospective study was performed, in which 75 patients who were diagnosed as having recurrent unilateral anterior instability of the shoulder underwent the biceps load test and arthroscopic examination. The biceps load test showed negative results in 64 of these patients, of which the superior labral-biceps complex was intact'in 63 cases and only I shoulder revealed a type n SLAP lesion. E]even patients with a positive test were confirmed to have type n SLAP lesions. A positive biceps load test represents an unstable SLAP lesion in a patient with recurrent anterior dislocation of the shoulder. The biceps load test is a reliable test for evaluating the SLAP lesion in the recurrent anterior dislocation of the shoulder(sensitivity: ,9] .7%, specificity: 100%, positive predictive value: 1.00 and negative predictive value: 0.98). Biceps contraction increases the torsional rigidity ?of the glenohumeral joint and long head of biceps tendan act as internal rotator of the shoulder in the abducted and externally rotated position. These stabilize the shoulder in abduction and external rotation position in the biceps load test.

• 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.

• The Academic Congress of Korean Shoulder and Elbow Society
• /
• 2001.03a
• /
• pp.123-128
• /
• 2001

in young, active, strenuous patients $\blacksquare$ stabilization for unstable SLAP lesion $\blacksquare$ tenodesis for ruptured biceps tendon above the groove $\blacksquare$ repair for ruptured biceps tendon below the groove $\blacksquare$ relocation for biceps instability in old, inactive patients $\blacksquare$ no need stabilization for unstable SLAP lesion $\blacksquare$ debride/tenotomy for partial ruptured biceps tendon $\blacksquare$ leave alone/trimming of stump for complete ruptured biceps tendon $\blacksquare$ tenodesis/in-site fixation for biceps instability

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.5 no.2
• /
• pp.110-116
• /
• 2006

Lesion of the superior glenoid labrum and the insertion of the biceps tendon are a common cause for shoulder pain in patients performing overhead sports. Medial shearing stress during overhead throwing may cause biceps instability and associated rotator cuff problem aggravates the symptoms. Careful attention to the history and physical examination and may arouse suspicion of injury to the biceps tendon and the superior labral complex. Progress in shoulder arthroscopy has led to the identification of the lesion and normal variation. Treatment should be directed according to the type of lesion and related symptoms.

• The Academic Congress of Korean Shoulder and Elbow Society
• /
• 2008.03a
• /
• pp.163-163
• /
• 2008

Calcific tendinitis is a common condition with characteristic clinical and radiological findings. Although we do not know which condition initiated the pathologic cascade, we present a rare case of calcific tendinitis of the long head of the biceps brachii at its origin, associated with a SLAP lesion. The calcium deposit was removed and the SLAP lesion was repaired with a suture anchor arthroscopically.

• 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.

• 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.

• The Journal of Korean Orthopaedic Ultrasound Society
• /
• v.8 no.1
• /
• pp.31-37
• /
• 2015

Lesion of long head of biceps tendon is one of the causes making an anterior shoulder pain. According to the anthropometric study of the bicipital groove the meanings of the width, depth and the medial wall angle were suggested. Confirming the images and location of the long head of biceps tendon itself would be helpful in diagnosis.

• Clinics in Shoulder and Elbow
• /
• v.1 no.2
• /
• pp.147-153
• /
• 1998

Biceps tendon dislocation combined with rupture of subscapularis tendon is not a common lesion and there has been few case reported in Korea. We experienced one fifty Six years old male patient who shows typical features on physical examination and roentgenographic finding. He was injured by direct trauma on his right shoulder in adducted and external rotated position. He showed positive findings on passive external rotation test and lift-off test. On MR!, the subscpaularis tendon was totally ruptured and the biceps tendon was dislocated to anteromedial aspect of the glenoid labrum, which was typical finding. On the arthroscopic examination, the subscapularis tendon was totally ruptured from its humeral attachment and the biceps tendon was not seen in its normal anatomical position and it was dislocated antermedially to the glenoid labrum. We repaired the subscapularis tendon to humerus by use of suture anchor and the biceps tendon was relocated to its normal anatomical position in the intertubercular groove. On the post operative 6 months follow up, the patient shows improvements in his subjective symptoms and active range of motion.

• Clinics in Shoulder and Elbow
• /
• v.17 no.3
• /
• pp.127-133
• /
• 2014

Heterotopic ossification (HO) within the substance of the subscapularis tendon is a rare lesion which remains a poorly described condition with little known of the exact mechanisms involved. Furthermore, its clinical importance remains still unclear. To our knowledge, there are no studies present to data regarding HO within the substance of the subscapularis tendon, even with resultant isolated complete tear of the subscapularis tendon. Here we present a case of huge HO associated with unusual isolated complete tear of subscapularis tendon concomitant with tear of biceps long head tendon. After arthroscopic debridement for the complete tear site of biceps long head tendon, mini-open excision of the ossification and subscapularis repair with suture anchor fixation were performed. The patient showed complete recovery of strength and function of the subscapularis at subsequent 24 months follow up.