Arthroscopic Versus Open Comparison of Long Head of Biceps Tendon Visualization and Pathology in Patients Requiring Tenodesis

Gilmer, Brian B.; DeMers, Ariana M.; Guerrero, Dolores; Reid, John B.; Lubowitz, James H.; Guttmann, Dan

doi:10.1016/j.arthro.2014.07.025

Cited by 77 publications

(60 citation statements)

References 28 publications

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“…Potential reasons for this include differing degrees of tethering by vinculae, scarring of the biceps tendon, and variations in overall anatomy between patients. 12 Furthermore, these data are consistent with work by Gilmer et al 11 who reported that only 5 to 28 mm of tendon could be visualized at the time of arthroscopy. However, in that study, in contrast to the authors' normal practice, a grasper was used instead of a hook.…”

Section: Discussionsupporting

confidence: 82%

“…Inability to visualize this region is an important cause of missed diagnoses, which are reported to occur at a rate of 30% to 50%. 9,11,16,22 This also implies that published figures for sensitivities and specificities of common physical examination tests and imaging modalities based on arthroscopy as a gold standard are invalid. [1][2][3]10,13 It would therefore be appropriate for further research to revisit these values based on open exploration to obtain valid data.…”

Section: Discussionmentioning

confidence: 99%

“…This is an important limitation of previous studies as not only is this technique not used in clinical practice but it also overestimates the amount of tendon that is normally visualized. 11,22 To our knowledge, there is only 1 published report of an atraumatic grasper technique. Parada et al 18 described using an Allis clamp and rotating the tendon around its closed jaws.…”

Section: Discussionmentioning

confidence: 99%

“…11,22 This adds to the increasing evidence that a ''normal'' standard arthroscopic examination of the LHB by pulling it into the joint with a hook and viewing with a 30 arthroscope is inadequate to exclude pathology and should no longer be relied upon to assess LHB pathology.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Shoulder arthroscopy does not adequately visualize pathology of the long head of biceps tendon

Old

Saithna

Longo

et al. 2017

Journal of Shoulder and Elbow Surgery

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Shoulder arthroscopy does not adequately visualize pathology of the long head of biceps tendon

Old

Saithna

Longo

et al. 2017

Journal of Shoulder and Elbow Surgery

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“…This includes physical therapy, exercises, anti-inflammatory medications and steroid injections, needling and shock-wave therapy. If this treatment fails, the surgery should be considered (8)(9)(10)(11). There are few contraindications for surgery and these include: medical preoperative status incompatible with surgery, local skin infection and a level of symptomatology that do not warrant surgical treatment (12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

Arthroscopic treatment for calcific tendinitis; a case report

Gavrilă¹,

Cristea²

2017

J Clin Invest Surg.

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Calcific tendinitis is a common cause of shoulder pain, peaking in the fourth and fifth decades of life. The excruciate pain; especially during the night is the symptom who brings patient to the doctor. In many cases conservative treatment is the best choice. Sometimes it doesn't work and is necessary operative treatment.It is presented a case of 60 years old women who had calcific tendinits for several years and accused pain few months with absence of improvement after conservative treatment. The patient was treated surgically with removal of calcium deposit arthroscopically. After surgery, pain relief was dramatic and movement increased rapidly. Results were very good with no complications.As a conclusion, arthroscopic evacuation of calcific deposit could be considered the best solution for patients whose symptomatology fail to improve after conservative treatment. 513-518,

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MRI findings and clinical testing for preoperative diagnosis of long head of the biceps pathology

Gallinet,

Antoni,

Berhouet

et al. 2024

J. exp. orthop.

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PurposeDetermine whether combining magnetic resonance imaging (MRI) observations and clinical tests could substantially improve sensitivity for diagnosis of long head of the biceps tendon (LHBT) pathology.MethodsThe authors retrospectively assessed a consecutive series of 140 patients who underwent arthroscopic rotator cuff repair for isolated supraspinatus tears. The presence of LHBT pathology was assessed preoperatively on MRI using three criteria and four clinical tests specific to shoulder injuries. Binary outcomes of MRI observations and four clinical tests were combined to identify combinations resulting in the best sensitivity using intra‐operative arthroscopic findings as reference.ResultsThe study cohort comprised 100 shoulders (58 men and 42 women) aged 56.6 ± 9.4 years (range, 30–76) at index surgery. A total of 29 combinations were tested to obtain the best diagnostic algorithm for LHBT pathologies. Only four combinations reached a sensitivity ≥0.75, but had a specificity <0.45. The ‘Speed or Signal’ combination achieved the highest sensitivity (Se: 0.88; 95% confidence interval [CI]: 0.73%–0.96%; Sp: 0.20; 95% CI: 0.10%–0.33%).ConclusionThe most important findings of this study were that, for the diagnosis of LHBT pathology using clinical tests alone, the Speed test had the highest sensitivity (Se, 0.74), and using MRI observations alone, the signal intensity had the highest sensitivity (Se, 0.68). Combination of ‘Speed test or Signal intensity’ substantially improved the sensitivity (Se, 0.88) but yielded the lowest specificity (Sp, 0.20). The clinical relevance of these findings is that using the combination ‘Speed or Signal’ for preoperative diagnosis, 88% of pathologic LHBTs would be correctly diagnosed, while 80% of healthy LHBTs could be misdiagnosed as pathologic.Level of EvidenceDiagnostic study, Level IV.

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Arthroscopic Versus Open Comparison of Long Head of Biceps Tendon Visualization and Pathology in Patients Requiring Tenodesis

Cited by 77 publications

References 28 publications

Shoulder arthroscopy does not adequately visualize pathology of the long head of biceps tendon

Shoulder arthroscopy does not adequately visualize pathology of the long head of biceps tendon

Arthroscopic treatment for calcific tendinitis; a case report

MRI findings and clinical testing for preoperative diagnosis of long head of the biceps pathology

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