Biceps tenotomy in the presence of a supraspinatus tear alters the adjacent intact tendons and glenoid cartilage

Beach, Zakary M; Tucker, Jennica J.; Thomas, Stephen J.; Reuther, Katherine E.; Gray, Chancellor F.; Lee, Chang‐Soo; Glaser, David L.; Soslowsky, Louis J.

doi:10.1016/j.jbiomech.2017.08.021

Cited by 4 publications

(8 citation statements)

References 37 publications

(77 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…30,31 Animal model studies report similar findings; there were lesser deforming forces in the shoulder joint and no functional differences after biceps tenotomy was performed. 32,33 Equal outcomes with no negative impact of biceps tenotomy on RC repair should reassure both patients and surgeons to proceed with taking down the BLHT if required or beneficial.…”

Section: Discussionmentioning

confidence: 99%

Does bicep pathology affect rotator cuff repair outcomes?

Mak

Tjoen

2018

J Orthop Surg (Hong Kong)

View full text Add to dashboard Cite

Introduction: Rotator cuff (RC) tears are common and a frequent cause of dysfunction in the shoulder, especially with progression of age. Biceps pathology occurs concomitantly and its relationship with RC tears has been well described. However, the study of biceps intervention affecting outcomes of RC repair is limited. We aim to study the effect of biceps tenotomy in RC repair after matching for cuff tear size. Methods: We collected data of 24 consecutive patients undergoing RC repair and biceps tenotomy and matched them with patients undergoing RC repair only (n ¼ 24). The groups were matched for age, RC tear size, and presence of subscapularis tears. All patients of this study underwent RC repair under a single surgeon. Patient demographics and outcome measures in the form of range of motion (ROM) pain scores and validated shoulder scores (Constant shoulder score, Oxford score, and University of California Los Angeles shoulder score) were collected preoperative and at predetermined fixed intervals up to 2 years postoperatively. We then compared the two groups using a mixed analysis of variance design so as to identify any possible differences. Results: Patients from both groups demonstrated significant improvement in ROM, lower pain scores, and improvement in functional outcomes (p < 0.05). Patients with biceps intervention demonstrated equivalent outcomes postoperatively up to 2 years with no statistical differences (p > 0.05). Conclusion: Arthoscopic RC repair is an effective intervention for improving ROM, reducing pain, and improving function. Concomitant biceps procedure did not negatively impede recovery or affect outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

Does bicep pathology affect rotator cuff repair outcomes?

Mak

Tjoen

2018

J Orthop Surg (Hong Kong)

View full text Add to dashboard Cite

show abstract

“…While short term studies have shown sacrifice of the long head of the biceps to be well tolerated, there is evidence [ 18 ] that sacrifice of the long head of the biceps with the short head intact can lead to an increased risk of shoulder impingement. There is also evidence [ 19 ] that a supraspinatus deficient shoulder will have increased stress and degeneration of the infraspinatus and subscapularis as well as the articular cartilage if the biceps is sacrificed. Thus the many patients in whom the biceps has been sacrificed in recent years may not manifest deleterious effects until many years in the future, if they develop rotator cuff pathology.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Type Two Slap Lesion With Anatomic Suture Anchor Repair Without Biceps Tenotomy Or Tenodesis

Prodromos¹,

Finkle²,

Dawes³

et al. 2018

TOORTHJ

View full text Add to dashboard Cite

Background:Poor results after repair of type 2 SLAP tears are relatively common and some have reported better results after biceps tenodesis or tenotomy than repair. In addition, some believe that the long head of the biceps is expendable. Therefore, many now favor biceps tenotomy or tenodesis over biceps anchor repair either in all patients or in older patients, reserving SLAP lesion repair only for young athletes.Hypothesis:We hypothesized that repair of the biceps anchor of the labrum would be effective in all patients regardless of age provided that care was taken not to overtighten the labrum and that rotator cuff pain as the primary pain generator had been ruled out.Methods:All patients with type 2 SLAP lesion repair by the senior author since he began repairing them with suture anchors were prospectively evaluated. Patients with more than one other concomitant procedure, simultaneous rotator cuff repair or worker’s compensation status were excluded.Results:77% of patients were available for minimum two year followup. No patient had subsequent surgery or manipulation under anesthesis as a result of their SLAP repair. Standardized shoulder test score increased by 4 points. Mean SANE score decreased from 53 pre-op to 14 post-op. Results were the same in those over versus under 40 years of age.Conclusion:Anatomic repair of Type 2 SLAP lesions at the biceps anchor without biceps tenodesis or tenotomy can produce good results in patients of all ages.

show abstract

“…Supraspinatus and infraspinatus (S+I) tendons were detached in right forelimbs of 28 male Sprague-Dawley rats (464±24g; IACUC approved) followed by 4 weeks of cage activity to create a model of chronic MRCT. 2, 23, 32 These animals with chronic MRCT were randomly divided into two groups that received either a surgical biceps tenotomy (BT, n=14) or a sham surgery (SS n=14) on the right shoulder (Fig. 1).…”

Section: Methodsmentioning

confidence: 99%

“…Supraspinatus and infraspinatus tendons were detached in the right forelimbs of 28 male Sprague-Dawley rats (mean ± SD: 464 ± 24 g; Institutional Animal Care and Use Committee approved; University of Pennsylvania), followed by 4 weeks of cage activity to create a model of chronic MRCT. 2,23,32 These animals with chronic MRCT were randomly divided into 2 groups that received either surgical BT (n = 14) or sham surgery (SS; n = 14) on the right shoulder (Figure 1). In vivo functional tests were performed with a customized quantitative ambulation device, followed by animal sacrifice for ex vivo analysis.…”

Section: Methodsmentioning

confidence: 99%

Biceps Detachment Preserves Joint Function in a Chronic Massive Rotator Cuff Tear Rat Model

et al. 2018

Self Cite

View full text Add to dashboard Cite

BACKGROUND: Lesions of the long head of the biceps tendon are often associated with massive rotator cuff tears (MRCT) and biceps tenotomy is frequently performed for pain relief and functional reservation. However, the efficacy and safety of biceps tenotomy regarding the effects on the surrounding tissues in chronic MRCT is unclear. HYPOTHESIS: We hypothesized that biceps tenotomy would result in improved mechanical and histological properties of the intact subscapularis tendon and improved in vivo shoulder function, while not compromising glenoid cartilage properties. STUDY DESIGN: Controlled laboratory study. METHODS: Right supraspinatus and infraspinatus tendons were detached in 25 male Sprague-Dawley rats, followed by 4 weeks of cage activity to create a chronic MRCT condition. Animals were randomly divided into 2 groups and received either a biceps tenotomy (n=11) or a sham surgery (n=14) and were sacrificed 4 weeks thereafter. Forelimb gait and ground reaction forces were recorded 1 day before the tendon detachment (baseline), 1 day before the surgical intervention (biceps tenotomy or sham), and 3, 7, 10, 14, 21 and 28 days after the intervention to assess in vivo shoulder joint function. The subscapularis tendon and glenoid cartilage were randomly allocated for either mechanical testing or histologic assessment after the sacrifice. RESULTS: Compared to sham group, biceps tenotomy partially restored the in vivo shoulder joint function, with several gait and ground reaction force parameters returning closer to pre-injury baseline values at 4 weeks. With biceps tenotomy, mechanical properties of the subscapularis tendons were improved while mechanical properties and histological Mankin score of the glenoid cartilage were not diminished compared to sham group. CONCLUSION: Biceps tenotomy in the presence of chronic MRCT partially preserves overall shoulder function and potentially restores subscapularis tendon health, without causing detrimental effects to joint cartilage. This laboratory study adds to the growing literature regarding the protective effects of biceps tenotomy on the shoulder joint in a chronic MRCT model. CLINICAL RELEVANCE: This study provides important basic science evidence supporting the use of biceps tenotomy in patients with massive rotator cuff tears.

show abstract

Biceps tenotomy in the presence of a supraspinatus tear alters the adjacent intact tendons and glenoid cartilage

Cited by 4 publications

References 37 publications

Does bicep pathology affect rotator cuff repair outcomes?

Does bicep pathology affect rotator cuff repair outcomes?

Treatment of Type Two Slap Lesion With Anatomic Suture Anchor Repair Without Biceps Tenotomy Or Tenodesis

Biceps Detachment Preserves Joint Function in a Chronic Massive Rotator Cuff Tear Rat Model

Contact Info

Product

Resources

About