Biceps Muscle Fatty Infiltration and Atrophy. A Midterm Review After Arthroscopic Tenotomy of the Long Head of the Biceps

Brutty, Mike; Wang, Allan; Wambeek, Nicholas; Campbell, Peter T.; Halliday, Michael J. C.; Ackland, Tim

doi:10.1016/j.arthro.2014.08.022

Cited by 5 publications

(6 citation statements)

References 26 publications

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“… 6 This may explain that muscles that are much less pennate than the rotator cuff muscles show less fatty infiltration after tendon tear than the cuff muscles. 12 , 13 …”

Section: Discussionmentioning

confidence: 99%

Muscle Degeneration Induced by Sequential Release and Denervation of the Rotator Cuff Tendon in Sheep

Wieser

Grubhofer

Hasler

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: In a sheep rotator cuff model, tenotomy predominantly induces fatty infiltration, and denervation induces mostly muscle atrophy. In clinical practice, myotendinous retraction after tendon tear or lateralization after tendon repair tear may lead to traction injury of the nerve. Purpose/Hypothesis: To analyze whether an additional nerve lesion during rotator cuff repair leads to further degeneration of the rotator cuff muscle in the clinical setting. We hypothesized that neurectomy after tendon tear would increase atrophy as well as fatty infiltration and that muscle paralysis after neurectomy would prevent myotendinous retraction after secondary tendon release. Study Design: Controlled laboratory study. Methods: Twelve Swiss alpine sheep were used for this study. For the 6 sheep in the tenotomy/neurectomy (T/N) group, the infraspinatus tendon was released; 8 weeks later, the suprascapular nerve was transected. For the 6 sheep in the neurectomy/tenotomy (N/T) group, neurectomy was performed, and the infraspinatus was tenotomized 8 weeks later. All sheep were sacrificed after 16 weeks. Magnetic resonance imaging (MRI) was performed before the first surgery (baseline) and then after 8 and 16 weeks. The MRI data were used to assess muscle volume, fat fraction, musculotendinous retraction, pennation angle, and muscle fiber length of the infraspinatus muscle. Results: Three sheep (2 in the T/N and 1 in the N/T group) had to be excluded because the neurectomy was incomplete. After 8 weeks, muscle volume decreased significantly less in the T/N group (73% ± 2% of initial volume vs 52% ± 7% in the N/T group; P < .001). After 16 weeks, the mean intramuscular fat increase was higher in the T/N group (36% ± 9%) than in the N/T group (23% ± 6%), without reaching significance ( P = .060). After 16 weeks, the muscle volumes of the N/T (52% ± 8%) and T/N (49% ± 3%) groups were the same ( P = .732). Conclusion: Secondary neurectomy after tenotomy of a musculotendinous unit increases muscle atrophy. Tenotomy of a denervated muscle is associated with substantial myotendinous retraction but not with an increase of fatty infiltration to the level of the tenotomy first group. Clinical Relevance: Substantial retraction, which is associated with hitherto irrecoverable fatty infiltration, should be prevented, and additional neurogenic injury during repair should be avoided to limit the development of further atrophy.

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“… 6 This may explain that muscles that are much less pennate than the rotator cuff muscles show less fatty infiltration after tendon tear than the cuff muscles. 12 , 13 …”

Section: Discussionmentioning

confidence: 99%

Muscle Degeneration Induced by Sequential Release and Denervation of the Rotator Cuff Tendon in Sheep

Wieser

Grubhofer

Hasler

et al. 2021

Orthopaedic Journal of Sports Medicine

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“…Como já foi relatado, a RM não permite a individualização do ventre muscular da cabeça longa e da cabeça curta do bíceps e a separação dos demais músculos do comparti-mento anterior do braço. 3,4 Por esse motivo, investigamos comparativamente a presença ou não de IG na massa muscular do compartimento anterior do braço usando cortes axiais ponderados em T1 obtidos o mais próximo possível da metade do comprimento do úmero nos dois grupos. Adaptamos a classificação IG existente 12 para comparação dos dois braços de cada paciente.…”

Section: Ressonância Magnéticaunclassified

“…Essa classificação sugere 5 graus de IG (grau 0: normal; grau 1: presença de algumas estrias de gordura; grau 2: < 50% de IG; grau 3: 50% de IG; grau 4: > 50% de IG); 13 embora essa classificação não tenha sido validada com imagens de RM do bíceps, foi usada para esse fim em um estudo recente. 4 As imagens foram avaliadas por um radiologista experiente, conhecedor do sistema musculoesquelético e com 15 anos de prática clínica.…”

Section: Ressonância Magnéticaunclassified

“…2 Apesar de muito estudado, não está bem estabelecido se o encurtamento crônico da massa muscular do bíceps pode causar uma alteração no ventre muscular semelhante àquela provocada pela IG no ventre dos músculos do manguito rotador em casos de rupturas crônicas acompanhadas por retração. 3,4 Em meados do século XX, o TCLB era visto como a principal fonte de dor no ombro, cujo tratamento era baseado em tenotomia e tenodese. [5][6][7] Hoje, esses procedimentos para o tratamento de lesões relacionadas ao TCLB são amplamente realizados durante artroscopias do ombro.…”

Section: Introductionunclassified

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Avaliação da tenotomia ou tenodese bicipital na infiltração gordurosa do músculo bíceps

Filho

Lara

Júnior³

et al. 2020

Rev Bras Ortop (Sao Paulo)

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Resumo Objetivo O objetivo do presente estudo foi determinar a existência de infiltração gordurosa (IG) na massa muscular do bíceps braquial após a tenotomia ou tenodese para tratamento de lesão no tendão da cabeça longa do bíceps e estabelecer uma relação entre a IG e alterações no comprimento das fibras musculares. Métodos Análise clínica e de imagens de 2 grupos de pacientes (submetidos à tenodese do bíceps [16 indivíduos] ou tenotomia do bíceps [15 indivíduos]). Nos dois grupos, os achados foram comparados àqueles do lado contralateral de cada indivíduo (grupo controle). Todos os pacientes foram submetidos à tenodese ou tenotomia unilateral do bíceps, com acompanhamento pós-operatório > 1 ano. Exames de ressonância magnética (RM) foram realizados em ambos os braços de cada paciente de acordo com um protocolo específico. A força de flexão do cotovelo foi medida com dinamômetro manual e os resultados foram submetidos à análise estatística. Resultados O período pós-operatório médio antes da realização da RM foi de 5 anos, e nenhum caso de IG foi observado no compartimento anterior de ambos os braços dos pacientes avaliados. Sete pacientes apresentaram deformidade moderada ou grave no braço operado. Não houve relação significativa entre deformidade do braço (p = 0,077), percentual de força de flexão (p = 0,07) ou dor à palpação do sulco bicipital (p = 0,103). Conclusão Nenhum dos pacientes avaliados apresentou evidência de IG na massa muscular do compartimento anterior do braço após os procedimentos. Não foi possível estabelecer uma correlação entre a discrepância do comprimento do músculo bíceps, medido à RM, e a presença de IG no compartimento anterior do braço.

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“…As we know prolonged, use of non-steroidal anti-inflammatory (NSAII) agents may cause nephrotoxic and gastrointestinal side effects [ 3 , 4 ]. Recent studies have reported that hyaluronic acid, intra-articular thrombocyte-rich plasma (PRP), and applications are particularly effective in treating knee OA [ 1 , 4 – 8 ]. Viscosupplementation may help pain reduction and functional improvement [ 5 , 6 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the short-term results of single-dose intra-articular peptide with hyaluronic acid and platelet-rich plasma injections in knee osteoarthritis: a randomized study

et al. 2020

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Introduction/objectives Intra-articular injections may be useful in terms of pain and functional status, in knee osteoarthritis (OA). Besides hyaluronic acid (HA) and platelet-rich plasma (PRP), peptide molecules recently begin to be used. The aim of this study was to compare the efficacy of intra-articular peptide Prostrolane® (CAREGEN Co. Ltd.) injection with that of the HA and PRP in the persons with OA. Method Fifty-four patients with OA were included in this prospective, randomized study. Patients were randomized into three groups as intra-articular HA, peptide, and PRP groups. Paracetamol was permitted three times a day to all groups. All the patients were evaluated by the Western Ontario and McMaster Universities Arthritis Index (WOMAC), Health Assessment Questionnaire (HAQ), and visual analogue scale (VAS) at rest and during movements. Measurements performed at the baseline, after the first week of injection, and at the first and third months of follow-up. Results Mean age was 55.8 ± 8.9 years. Forty-four (81.6%) were women. A week after the injections, rest and movement pain severity was measured by VAS decreased significantly in all the study groups (p < 0.05). There were no statistically significant differences between the groups in terms of first week pain relief (p > 0.05). WOMAC pain, stiffness, function, and total scores were improved significantly in all the groups a week after the injections (p < 0.05). Improvement continued at the third month control; however, the improvement in the WOMAC pain score was significantly better in the peptide group at the third month control (p < 0.05). The decrease in the rest and movement pain was continued for 3 months except the HA group’s rest pain. There were no differences among the groups for all measurements, except for the WOMAC pain score at 3 months after treatment, which was significantly lower in the peptide group. Conclusion As a result, pain relief and functional improvement were obtained after the intra-articular HA, peptide, and PRP injections in OA, and decrease in pain was better in the peptide group. Key Points• The short-term effects of intra-articular HA, peptide, and PRP injections were compared in knee osteoarthritis.• HA, peptide, and PRP injections may be useful in pain relief and functional improvement in knee osteoarthritis.

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Biceps Muscle Fatty Infiltration and Atrophy. A Midterm Review After Arthroscopic Tenotomy of the Long Head of the Biceps

Cited by 5 publications

References 26 publications

Muscle Degeneration Induced by Sequential Release and Denervation of the Rotator Cuff Tendon in Sheep

Muscle Degeneration Induced by Sequential Release and Denervation of the Rotator Cuff Tendon in Sheep

Avaliação da tenotomia ou tenodese bicipital na infiltração gordurosa do músculo bíceps

Comparison of the short-term results of single-dose intra-articular peptide with hyaluronic acid and platelet-rich plasma injections in knee osteoarthritis: a randomized study

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