Popeye sign: Frequency and functional impact

Pouliquen, L; Berhouet, Julien; Istvan, Marion; Thomazeau, H.; Ropars, M.

doi:10.1016/j.otsr.2018.02.016

Cited by 13 publications

(5 citation statements)

References 26 publications

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“…Progressive friction of an inflamed tendon during shoulder movements may lead to tendon rupture, typically occurring at the proximal attachment or at the musculotendinous junction. Ruptures are often associated with symptomatic relief and a deformity of the distal humerus called the Popeye sign ( 23 ). These ruptures are more frequently observed in individuals over the age of 50, with an incidence rate of over 95%, surpassing that of the short head portion or the distal biceps ( 24 ).…”

Section: Lhbt’s Role In Shoulder Pathologiesmentioning

confidence: 99%

Biceps tendon autograft augmentation for rotator cuff and instability procedures: a narrative review

Laprus,

Juszczak,

Brzóska

et al. 2024

EFORT Open Reviews

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Rotator cuff tears (RCT) and instability are the most common surgically treated shoulder pathologies. The concept of augmentation using the long head of the biceps tendon (LHBT) autograft was created to improve the results of surgical treatment of these pathologies, especially in cases of chronic and massive injuries. The popularity of using the LHBT for augmentation is evidenced by the significant number of publications on this topic published in the last 3 years; however, only one systematic review has been published regarding only LHBT augmentation for massive RCTs. Several studies comparing partial repair with partial repair and additional LHBT augmentation for RCT showed superior clinical outcomes and lower re-tear rates when LHBT augmentation was performed. There is a rising popularity of using LHBT as an autograft to perform superior capsule reconstruction (SCR) in case of irreparable rotator cuff tears. In recent years, shoulder stabilization by arthroscopic Bankart repair with biceps augmentation has been promoted with very promising short-term results. The evidence provided by studies appears to be sufficient to recommend the use of LHBT for augmentation whenever necessary; however, larger studies with long-term follow-up are needed.

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Section: Lhbt’s Role In Shoulder Pathologiesmentioning

confidence: 99%

Biceps tendon autograft augmentation for rotator cuff and instability procedures: a narrative review

Laprus,

Juszczak,

Brzóska

et al. 2024

EFORT Open Reviews

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“…However, It may cause several inconveniences, like Popeye's sign (PS), which is the distal retraction of the biceps muscular body. (3,4) Tenodesis of the LHB consists of fixing the biceps at the level of the bicipital groove, avoiding the appearance of PS, with a higher cost, technical difficulty and more constraining postoperative recovery. (5,6) From a functional point of view, there was no significant difference between the two techniques.…”

Section: Introductionmentioning

confidence: 99%

Self-locking tenotomy of the long head of the biceps: What is the benefit?

YASSER SBIHI,

OUSSAMA EL ADAOUI,

YASSIR EL ANDALOUSSI

et al. 2024

World J. Adv. Res. Rev.

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Tenotomy and tenodesis of the biceps are the surgical techniques used to treat pathology of the long biceps. Between the proponents of the two techniques, the superiority of one over the other is still debated. The Popeye sign is often cited to the disadvantage of tenotomy. The aim of our study is to report on our experience using a self-locking tenotomy and its impact on Popeye's sign, and to assess our functional results. This is a retrospective study of 53 shoulders treated for long biceps tendinopathy, isolated or associated with a rotator cuff tear. All patients underwent surgery at the AILE 4 orthopedic department of the Ibn Rochd University Hospital in Casablanca over a period of five years, and were reviewed at least six months later. A self-locking tenotomy was performed in all patients. The mean age at surgery was 58 years. Popeye's sign was observed in five patients and was well accepted in four patients. Constant-Murray scores improved significantly by an average of 25 points. Satisfaction was over 90%. Professional and sporting activities were resumed in all patients. We highlight the value of the self-locking tenotomy as a simple, rapid, reproducible, effective and low-cost arthroscopic technique, ensuring a tenodesis effect by reducing the rate of appearance of Popeye's sign.

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“…Many studies aimed to compare tenodesis and tenotomy [ 8 , 9 , 10 , 11 ], while only a few studies focused specifically on tenotomy in combination with rotator cuff repair (RCR), trying to consider specific risk factors [ 12 , 13 , 14 ]. Common drawbacks related to tenotomy include the occurrence of the popeye sign, bicipital cramps, and reduced elbow strength [ 6 , 15 , 16 ]. In contrast, advantages are related to a quicker recovery, ease of execution, reduced complications, and lesser costs [ 6 , 9 , 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Complications of Long Head of the Biceps Tenotomy in Association with Arthroscopic Rotator Cuff Repair: Risk Factors and Influence on Outcomes

Ranieri

Nabergoj

et al. 2022

JCM

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Background: This study aims to report the rate of biceps-related complications after LHB tenotomy, investigating related risk factors and their influence on the outcome. The hypothesis is that these complications have a limited clinical influence. Methods: A single-center prospective observational study was performed between 2015 and 2017 on consecutive patients who underwent RCR associated with LHB tenotomy. Patients were clinically and radiologically evaluated preoperatively, at six months and one year, and screened for postoperative popeye deformity, cramps, and bicipital discomfort. Each complication was analyzed for the following risk factors: age, sex, body mass index (BMI), dominant arm, manual work, tear patterns, and tendon healing. Finally, the clinical outcome was compared between patients with and without complications. Results: 207 patients were analyzed. Cramps, popeye deformity, and discomfort, were respectively, present in 16 (7.7%), 38 (18.4%) and 52 (25.1%) cases at six months and 17 (8.2%), 18 (8.7%) and 24 (11.6%) cases at one year. Cramps were associated with lower age (p = 0.0005), higher BMI (p = 0.0251), single tendon tear (p = 0.0168), manual work (p = 0.0086) at six months and manual work (p = 0.0345) at one year. Popeye deformity was associated with male sex at six months (p < 0.0001). Discomfort was associated with lower age (p = 0.0065), manual work (p = 0.0099), popeye deformity (p = 0.0240) at six months and manual work (p = 0.0200), single tendon tear (p = 0.0370), popeye deformity (p = 0.0033) at one year. Patients without complications showed a significant higher Constant score, pain and subjective shoulder value (SSV) (75.3 vs. 70.4, p = 0.00252; 0.9 vs. 1.9, p < 0.00001; 80.2 vs. 76.4; p = 0.00124) at six months and pain and SSV (0.6 vs. 2.0; p = 0.00044; 91.1 vs. 77.8; p ≤ 0.00001) at one year. Conclusions: Younger age, male sex, higher BMI, manual work, and single tendon tears are risk factors associated with the development of biceps-related symptoms during the first year after tenotomy in association with rotator cuff repair. Nevertheless, the clinical influence of these symptoms on shoulder outcomes is limited.

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Popeye sign: Frequency and functional impact

Abstract: IV, prospective non-randomized.

Cited by 13 publications

References 26 publications

Biceps tendon autograft augmentation for rotator cuff and instability procedures: a narrative review

Biceps tendon autograft augmentation for rotator cuff and instability procedures: a narrative review

Self-locking tenotomy of the long head of the biceps: What is the benefit?

Complications of Long Head of the Biceps Tenotomy in Association with Arthroscopic Rotator Cuff Repair: Risk Factors and Influence on Outcomes

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