Arthroscopic Superior Capsular Reconstruction With Biceps Autograft: Snake Technique

Kim, Doo-Sup; Jang, Young-Hwan; Park, Jisu; On, Myounggi

doi:10.1016/j.eats.2019.05.023

Cited by 27 publications

(45 citation statements)

References 25 publications

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“…Ten studies did not fulfill the inclusion criteria, leaving 13 studies for inclusion in the review ( Figure 1 ). Nine studies described relevant surgical techniques without clinical outcomes [ 7 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ], while the remaining four were clinical studies [ 2 , 24 , 25 , 26 ].…”

Section: Resultsmentioning

confidence: 99%

“…Nine studies described SCR using the LHBT without clinical outcomes and the dates of publication ranged between 2017 and 2020 [ 7 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ]. Four studies were conducted in Asia [ 16 , 19 , 21 , 22 ], three in Europe [ 17 , 20 , 23 ], one in North America [ 18 ], and one included authors both from Asia and Europe [ 7 ].…”

Section: Resultsmentioning

confidence: 99%

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Superior Capsular Reconstruction of the Shoulder Using the Long Head of the Biceps Tendon: A Systematic Review of Surgical Techniques and Clinical Outcomes

Kitridis¹,

Yiannakopoulos²,

Sinopidis³

et al. 2021

Medicina

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Background and Objectives: Superior capsular reconstruction (SCR) with the use of a fascia lata autograft or a dermal allograft is an established treatment in treating irreparable rotator cuff (RC) tears. The long head of the biceps tendon (LHBT) has been recently proposed as an alternative graft for SCR. The purpose of this study was to present the surgical techniques and clinical studies utilizing the LHBT for SCR. Material and Methods: Medline, Scopus, and the Cochrane library were searched for relevant studies up to December 2020. The primary outcomes were pain intensity improvement and the incidence of RC and LHBT graft retears. Secondary outcomes were functional scores and acromiohumeral distance (AHD) improvements. Results: Nine studies described surgical techniques of SCR using the LHBT, and four clinical studies reported the outcomes of the technique. The mean pain intensity improved from 4.9 ± 2.3 to 1.6 ± 1.5 in terms of the visual analog scale, exceeding the minimum clinically important difference for adequate pain relief. Significant improvements were also noted in functional scores and AHD. When compared with other repair techniques for massive RC tears, i.e., the double-row repair, the transosseous-equivalent technique with absorbable patch reinforcement, and the traditional SCR with a fascia lata autograft, there were no significant differences in pain and function improvements. Conclusion: SCR using the LHBT is a useful treatment option for massive RC tears; it is equally effective with the traditional SCR and other established techniques. It presents numerous advantages being a safe, easy, time-saving, and cost-effective method. The only precondition for the technique is the presence of an intact LHBT. Additional clinical trials are necessary to determine which treatment is superior for treating massive RC tears, as well as to evaluate the long-term results of the technique.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Superior Capsular Reconstruction of the Shoulder Using the Long Head of the Biceps Tendon: A Systematic Review of Surgical Techniques and Clinical Outcomes

Kitridis¹,

Yiannakopoulos²,

Sinopidis³

et al. 2021

Medicina

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“…The LHB tendon can be used as a single-string, 4 , 5 double-string, 6 or triple-string structure. 7 The simplest way is to cut out the LHB tendon and use it as free graft tissue. 8 All these methods try to bridge the rotator cuff or glenoid and the humeral head (rotator cuff or superior capsular reconstruction).…”

Section: Discussionmentioning

confidence: 99%

Dynamic Biceps Rerouting for Irreparable Posterior-Superior Rotator Cuff Tear

Tang

Zhao

2020

Arthroscopy Techniques

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Irreparable posterior-superior rotator cuff tear (IPSRCT) is a common clinical condition. Many methods of transfer of the long head of the biceps (LHB) have been developed to augment the shoulder superiorly, with the best method using the LHB still being pursued. In this article, we introduce a special method using the LHB to address IPSRCT: arthroscopic dynamic LHB rerouting. The main steps of this technique include opening the native bicipital groove, creating a new bicipital groove through the greater tuberosity, rerouting the LHB into the new bicipital groove without LHB fixation, and side-to-side rotator cuff repair over the LHB. Our clinical experience indicates this technique can be easily and safely performed according to certain guidelines. We think the introduction of this technique will bring special insight to superior shoulder augmentation in case of IPSRCT.

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“…Currently, LHBT was considered as a suitable and locally available graft for SCR [20]. The intraarticular portion of LHBT was cut distally and xed to greater tuberosity by either suture anchors [20][21][22] or transosseous suture [23]. While LHBT was used to bridge superior glenoid and greater tuberosity similar to FL in SCR, general concerns in those techniques are regarding the size and quality of tendon graft.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic superior capsule reconstruction using autologous fascia lata and biceps tendon augmentation

Hsu

Chiu

Weng

et al. 2020

Preprint

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Background While arthroscopic superior capsule reconstruction (SCR) has been recently introduced to treat irreparable rotator cuff tear with encouraging outcomes, graft options and fixation remain debated. The purpose of this article is to describe a novel technique and present preliminary results in using long head of biceps tendon (LHBT) as augmentation for SCR with fascia lata autograft. Methods Retrospective analysis was performed on 18 patients undergoing arthroscopic SCR with LHBT augmentation for irreparable rotator cuff tear between October 2017 and November 2019. Preoperative radiographic survey confirmed massive rotator cuff tear with moderate to severe muscle fatty infiltration and availability of LHBT. Fascia lata autograft harvested from ipsilateral thigh was folded and securely sutured. The folded fascia graft was then introduced through standard anterolateral portal and fixed to superior glenoid superiorly and greater tuberosity laterally with suture anchors. Anteriorly, fascia lata graft was sutured with proximal portion of LHBT instead of subscapularis tendon. A full coverage of rotator cuff defect by facial graft was then confirmed arthroscopically to allow tension-free suturing between posterior margin of fascia graft and residual infraspinatus tendon. Postoperative abduction brace and regular follow-up was arranged. Results Being intact in 4 patients and either partially torn or subluxed in 14 patients, LHBT in all 18 patients were available for augmentation surgery. Preliminary functional survey revealed encouraging outcomes with a mean follow-up of 11.5 months. Nine patients with more one year follow-up regained full forward elevation; ASES improved from 24.3 to 90.2. Acromiohumeral distance improved from 3.3 mm to 8.6 mm with radiographic analysis in those 9 patients. Conclusions Arthroscopically LHBT augmented SCR is a novel technique and can be one of feasible opinions for irreparable rotator cuff tear.

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Arthroscopic Superior Capsular Reconstruction With Biceps Autograft: Snake Technique

Cited by 27 publications

References 25 publications

Superior Capsular Reconstruction of the Shoulder Using the Long Head of the Biceps Tendon: A Systematic Review of Surgical Techniques and Clinical Outcomes

Superior Capsular Reconstruction of the Shoulder Using the Long Head of the Biceps Tendon: A Systematic Review of Surgical Techniques and Clinical Outcomes

Dynamic Biceps Rerouting for Irreparable Posterior-Superior Rotator Cuff Tear

Arthroscopic superior capsule reconstruction using autologous fascia lata and biceps tendon augmentation

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