Avaliação da deformidade estética após a tenotomia da cabeça longa do bíceps na artroscopia do ombro

Almeida, Alexandre; Roveda, Gilberto; Valin, Márcio Rangel; Almeida, Nayvaldo Couto de; Agostini, Ana Paula; Scheifler, Camila

doi:10.1590/s0102-36162008000700002

Cited by 9 publications

(13 citation statements)

References 21 publications

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“…Besides the concern with the cosmetic aspect, the possible deficit of strength at the level of the elbow and forearm is a recommendation for tenodesis instead of tenotomy, in patients under 55 years of age (3) . Almeida et al (14) did not find statistical significance when they performed the cross-evaluation between the patients' ages and the esthetic complaint of residual deformity.…”

Section: Discussionmentioning

confidence: 95%

Tenodese bicipital "a rocambole": técnica e resultados

Godinho¹,

Mesquita²,

França³

et al. 2011

Rev. bras. ortop.

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This article is available online in Portuguese and ABSTRACTObjective: To present a new technique for bicipital tenodesis and its results: accomplished partially via arthroscopy and grounded in concepts of the normal and pathological anatomy of the tendon of the biceps long head. It is based on the predisposition of this tendon towards becoming attached to the intertubercular sulcus after rupture or tenotomy (auto-tenodesis). Methods: Evaluations were conducted on 63 patients (63 shoulders), aged from 32 to 77 years (average 55), consisting of 32 females (51%) and 31 males (49%). Thirty-five of the patients (55.6%) were over 60 years of age and 28 patients (44.4%) were under 60 years of age. Eighteen were sports participants (28.6%). Fourteen had injuries associated with the subscapularis (22.2%). The average follow up was 43 months (ranging from 12 to 74 months). The right shoulder accounted for 48 cases (76.2%), of which one was a left-handed individual and 47 were right-handed. The left shoulder accounted for 15 (23%) of the patients, of whom two were left-handed and 13 were right-handed. There were no bilateral occurrences. The statistical analysis were done using SPSS version 18. Pearson's chi-square test and continuity corrections were used to investigate the statistical significance of associations between variables. Associations were taken to be statistically significant when p was less than 0.05. Results: Residual Popeye deformity was perceived by seven patients (11.1%); it was only observed by the examiner in 15 cases (23.8%); and neither the patient nor the examiner observed it in 41 cases (65%). There were no statistically valid influences from age, participation in contact or throwing sports, subscapularis tendon-associated injury or Popeye deformity. Fifty-eight patients (92.06%) were satisfied, two patients were dissatisfied (3.17%) and three patients were indifferent (4.76%). Conclusion: The technique presented high patient satisfaction rates (92.06%) and residual deformity was perceived by 11.1% of the patients. The appearance did not have any statistically valid correlation with ages over or under 60 years (p = 0.883), sports practice (p = 0.195) or subscapularis-associated injury (p = 0.958).

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Section: Discussionmentioning

confidence: 95%

Tenodese bicipital "a rocambole": técnica e resultados

Godinho¹,

Mesquita²,

França³

et al. 2011

Rev. bras. ortop.

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“…Walch et al 8 reported the difficulty in assessing the presence of deformity in obese or elderly patients with poor muscle tone, eventually classifying them as doubtful. Almeida et al, 22 also observed in a statistically significantly manner (p = 0.005) that obese patients perceive less the aesthetic deformity.…”

Section: Discussionmentioning

confidence: 85%

“…Boileau et al 21 reported that their patients perceived the deformity in 66.6% of cases where isolated tenotomy of LHB was performed, without clinical or aesthetic significance. Almeida et al 22 found aesthetic complaint in 35.1% of the sample. Maynou et al 13 noticed complaint to the asymmetry of the UL in only 5% of their patients.…”

Section: Discussionmentioning

confidence: 91%

“…Most studies question patients about the perception or not of aesthetic deformity resulting from tenotomy of LHB, these rates vary between 5 and 65%. 8 , 13 , 21 - 28 Almeida et al 22 showed that the perception of aesthetic deformity by patient was higher in men with the operated dominant upper limb (UL), BMI < 30 kg/m 2 , abdominal skinfold < 23.2 mm and contralateral tricipital fold < 14.5 mm. Godinho et al 28 stated that the assessment of cosmetic deformity is more concise when performed by an professional orthopedist.…”

Section: Introductionmentioning

confidence: 99%

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Interprofessional analysis of esthetical deformity from long head biceps tenotomy

Almeida¹,

Valin²,

Lotti³

et al. 2015

Acta ortop. bras.

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OBJECTIVE: To evaluate the perception of an esthetical deformity resultant from arthroscopic long head biceps (LHB) tenotomy according to the degree of experience of the assisting professional. METHODS: 120 patients submitted to shoulder surgery were photographed and photos were mounted in a PowerPoint presentation. Three shoulder specialist surgeons, three generalist orthopedic surgeons and three graduated residents analyzed the presentation. RESULTS: On all patients we observed most agreement among the shoulder specialists. When just the patients with LHB tenotomy were analyzed, the specialists agreed moderately, the generalists had small agreement and the residents, a poor one. Analyzing patients with BMI < 30, there was major agreement between the specialists, while the generalists and residents had poor agreement. Analyzing patients with BMI ≥ 30, the generalists had small kappa agreement, while the specialists and residents had no agreement. CONCLUSIONS: The perception of an esthetical deformity regarding a LHB tenotomy did not have significant agreement between different level of professionals, even though the specialists showed similar perception on tenotomy patients. The evaluation of obese patients lowered the agreement on the three groups of professionals. Level of Evidence III. Case Control Study.

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“…In another prospective cohort study, Almeida et al 35 evaluated the presence of esthetic deformity after arthroscopic LHB tenotomy and concluded that the Popeye deformity was present in 35.1% of the sample. Male patients, those with BMI below 30, and those who were operated on the dominant limb had more esthetic complaints.…”

Section: Resultsmentioning

confidence: 99%

Disorders of the long head of the biceps: tenotomy versus tenodesis

Ribeiro

Ursolino

Ramos

et al. 2017

Revista Brasileira de Ortopedia (English Edition)

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Disorders of the long head of biceps tendon are common in clinical practice. Their causes could be degenerative, inflammatory, instability (subluxation or luxation) or traumatic. They are generally associated to other diseases of the shoulder, mainly rotator cuff injuries. Currently, there is controversy in the literature regarding the indications for surgical treatment and the choice of the best technique for each case, due to the possibility of esthetic deformity, loss of muscle strength, and residual pain.The objective of this study was to identify the indications for surgical treatment, the best surgical technique, and the advantages and disadvantages of each technique described in the orthopedic literature for the treatment of long head of biceps tendon injuries.A revision of the orthopedic medical literature on the following databases: Biblioteca Regional de Medicina (BIREME), Medline, PubMed, Cochrane Library and Google Scholar, comprising articles published in the period from 1991 to 2015.

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Avaliação da deformidade estética após a tenotomia da cabeça longa do bíceps na artroscopia do ombro

Cited by 9 publications

References 21 publications

Tenodese bicipital "a rocambole": técnica e resultados

Tenodese bicipital "a rocambole": técnica e resultados

Interprofessional analysis of esthetical deformity from long head biceps tenotomy

Disorders of the long head of the biceps: tenotomy versus tenodesis

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