Effect of biceps rerouting technique to restore glenohumeral joint stability for large irreparable rotator cuff tears: a cadaveric biomechanical study

Han, Seung Hee; Lee, Thay Q.; Wright, David J.; Park, Il-Jung; Maniglio, Mauro; McGarry, Michelle H.; Kim, Yang-Soo

doi:10.1016/j.jse.2019.11.015

Cited by 23 publications

(35 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The LHBT is not as wide as the fascia lata or the dermal graft and has been criticized as not being suitable for SCR because the smaller surface coverage of the humeral head may lead to its superior escape. However, recent biomechanical studies have shown that SCR with the LHBT, especially when combined with side-to-side anterior and posterior marginal repair of the RC with the LHBT, re-centers the humeral head on the glenoid, prevents the superior humeral migration, and is equivalent to a fascia lata graft [34][35][36][37].…”

Section: Interpretation Of the Results In The Context Of The Literaturementioning

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

View full text Add to dashboard Cite

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.

show abstract

Section: Interpretation Of the Results In The Context Of The Literaturementioning

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

View full text Add to dashboard Cite

show abstract

“…Auch diese Technik ist in der Lage, den Humeruskopf zu rezentrieren. Darüber hinaus werden der subakromiale Spitzendruck und die Kontaktfläche von Humerus und Glenoid signifikant verringert [12,13]. Ebenso konnte bewiesen werden, dass auch das Fortschreiten von Arthrose oder die Atrophie der Muskulatur der Rotatorenmanschette durch dieses Verfahren verlangsamt werden kann [14].…”

Section: Diskussionunclassified

Superiore Kapselrekonstruktion mittels langer Bizepssehne bei retrahierter Komplettruptur der Supraspinatussehne und der kranialen Infraspinatussehne

2020

View full text Add to dashboard Cite

ZusammenfassungIn diesem Beitrag berichten die Autoren über einen Patienten mit einer Ruptur der Rotatorenmanschette, welche sich als retrahierte Komplettruptur der Supraspinatussehne und der kranialen Infraspinatussehne präsentierte. Nach 7‑monatiger Schmerzpersistenz und anhaltendem Funktionsverlust wurde im Rahmen eines arthroskopischen Eingriffs eine Rekonstruktion der superioren Kapsel durchgeführt. Die lange Bizepssehne wurde hierzu als Autograft verwendet und mit der kranialen Infraspinatussehne verknüpft. Auf diese Weise konnte ein kompletter Verschluss des posterosuperioren Gelenkraums erreicht werden.

show abstract

“…28,36 The lack of a superior restraint that depresses the humeral head leads to a loss of appropriate mechanics and severely impaired range of shoulder motion in patients with IRCT. 1,11,14,26 Thus, the essential role of the superior capsule in preventing the humeral head from superior migration has attracted more attention in IRCT treatment. 26,36 Given this background, superior capsular reconstruction (SCR) using a tensor fascia lata autograft has been proposed by surgeons.…”

mentioning

confidence: 99%

“…9,25 Promising clinical and biomechanical outcomes of SCR have been reported in some studies; however, there are some potential drawbacks, such as surgical difficulty, donor-site morbidity, and time-consuming tensor fascia lata harvest. 11,14,25,26 Moreover, the use of dermal allografts instead of tensor fascia lata for SCR increases the possibility of infection, and the biological healing potency remains unclear.…”

mentioning

confidence: 99%

The Biomechanical and Histological Processes of Rerouting Biceps to Treat Chronic Irreparable Rotator Cuff Tears in a Rabbit Model

Zhang

et al. 2022

Am J Sports Med

View full text Add to dashboard Cite

Background: Recently, the biceps was rerouted into a newly fabricated bicipital groove for in situ superior capsular reconstruction (SCR), resulting in promising time-zero cadaveric and clinical outcomes. However, no studies have determined the in vivo biomechanical and histological processes after the biceps is transposed to a nonanatomic position. Purpose: To explore the in vivo biomechanical and histological processes of the rerouting biceps tendon to treat chronic irreparable rotator cuff tears (IRCTs) in a rabbit model. Study Design: Controlled laboratory study. Methods: A total of 94 skeletally mature male rabbits were used to create a chronic IRCT model in the supraspinatus tendon. Then, the biceps rerouting procedures were performed in rabbits with chronic IRCT. Eighteen rabbits were sacrificed at 1, 3, 6, 9, and 12 weeks postoperatively for biomechanical testing, micro—computed tomography scanning, and histological analysis. The biomechanical and histological changes of intra- and extra-articular portions of the rerouting biceps were evaluated at each time point, with the contralateral native superior capsule (NSC) and the native biceps (NB) as controls, respectively. The morphology and bone formation of the fabricated bicipital grooves were evaluated, with native grooves as controls. Results: The intra-articular rerouting biceps tendon was progressively remodeled over time, displaying denser fibers and more mature collagen than those of the NSC, with gradual improvements in the tendon-to-bone healing interface from 6 to 12 weeks. Consequently, the failure load and stiffness of the intra-articular rerouting biceps portion increased with time and were significantly higher than those of the NSC from 9 weeks. Similarly, the extra-articular portion of the rerouting biceps progressively healed into a new bicipital groove, as demonstrated by a smaller tendon-to-bone interface from 6 to 12 weeks, resulting in greater failure load and stiffness at 9 and 12 weeks than those of the NB attachment. The newly fabricated bicipital groove showed similar morphology to that of the native groove with sufficient trabecular bone formed underneath. Conclusion: The rerouting biceps could progressively remodel and heal into the newly fabricated bicipital groove over time, resulting in greater biomechanical performances in intra- and extra-articular portions than the NSC and the NB attachment. Clinical Relevance: The biceps rerouting technique may be a feasible procedure to perform in situ SCR to treat IRCT in the future clinical practice; however, more clinical evidence is required.

show abstract

Effect of biceps rerouting technique to restore glenohumeral joint stability for large irreparable rotator cuff tears: a cadaveric biomechanical study

Cited by 23 publications

References 30 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

Superiore Kapselrekonstruktion mittels langer Bizepssehne bei retrahierter Komplettruptur der Supraspinatussehne und der kranialen Infraspinatussehne

The Biomechanical and Histological Processes of Rerouting Biceps to Treat Chronic Irreparable Rotator Cuff Tears in a Rabbit Model

Contact Info

Product

Resources

About