A total of 138 patients using elbow crutches after endoprothetic joint replacement of the hip or knee were examined for effusion of the biceps tendon sheath using ultrasound sonography. A surprisingly high number of patients showed liquid effusion around the long biceps tendon area (69 patients, 50%). Tenosynovitis was associated with a liquid effusion of the glenohumeral joint in only 5 cases, whereas isolated tenovaginitis was seen in the large majority of the cases. This leads to the hypothesis that axial-mediated stress is the pathogenetic mechanism and causes a functional impingement as a result of high positioning of the caput humeri by the use of crutches. Further investigations are necessary to find out why the inflammation is limited to the anterior recessus region (Sulcus intertubercularis) of the glenohumeral joint.
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