Avaliação da deformidade estética após a tenotomia da cabeça longa do bíceps na artroscopia do ombro Avaliação da deformidade estética após a tenotomia da cabeça longa do bíceps na artroscopia do ombro * Assessment of esthetic deformity after tenotomy of the long head of the biceps in shoulder arthroscopy

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Objective: To comparatively analyze the results from arthroscopic rotator cuff suture between smoking and non-smoking patients. Methods: A group of 286 patients who underwent arthroscopic suturing of primary rotator cuff injuries between June 12, 2002, and May 14, 2008, was analyzed. The patients included in the study were evaluated using the UCLA scale, with a minimum follow-up of 12 months and average of 56.52 months. The variables studied were age, sex, side operated, dominance, profile of cigarette use and UCLA index. Results: This study evaluated a total of 205 patients. Mean age (p = 0.289) and sex (p = 0.124) were analyzed statistically between the smoking and non-smoking patients and the two groups were considered to be similar. The average UCLA score for the non-smoking patients (143) was 34 (32 to 35). The average UCLA score for the smoking patients (51) was 33 (29 to 35). There was no statistically significant difference in UCLA score (p = 0.123) between the smoking and non-smoking patients. For the purposes of statistical analysis, we grouped the small and medium tears (107) and compared these with the large and extensive tears (80), between smokers and non-smokers. There was no statistically significant difference using the Mann-Whitney test regarding the small and medium tears (p = 818). There was a statistically significant difference using the Mann-Whitney test regarding the large and extended tears, between the smoking and non-smoking patients, such that the non-smokers showed better UCLA scores (p = 0.038). Conclusion: The results from arthroscopic suturing of large and extensive rotator cuff injuries are inferior among smoking patients.

OBJECTIVE: To evaluate the perception of an esthetical deformity resultant from arthroscopic long head biceps (LHB) tenotomy according to the degree of experience of the assisting professional. METHODS: 120 patients submitted to shoulder surgery were photographed and photos were mounted in a PowerPoint presentation. Three shoulder specialist surgeons, three generalist orthopedic surgeons and three graduated residents analyzed the presentation. RESULTS: On all patients we observed most agreement among the shoulder specialists. When just the patients with LHB tenotomy were analyzed, the specialists agreed moderately, the generalists had small agreement and the residents, a poor one. Analyzing patients with BMI < 30, there was major agreement between the specialists, while the generalists and residents had poor agreement. Analyzing patients with BMI ≥ 30, the generalists had small kappa agreement, while the specialists and residents had no agreement. CONCLUSIONS: The perception of an esthetical deformity regarding a LHB tenotomy did not have significant agreement between different level of professionals, even though the specialists showed similar perception on tenotomy patients. The evaluation of obese patients lowered the agreement on the three groups of professionals. Level of Evidence III. Case Control Study.

REsUMOObjetivo: Avaliar o resultado da reconstrução do ligamento cruzado anterior (LCA) com o autoenxerto dos tendões flexores da coxa. Serão analisados os dados com relação ao sexo, ao índice de massa corporal (IMC) e a associação com fratura no membro inferior (MI). Métodos: Foi analisado um grupo de 265 pacientes submetidos à artroscopia do joelho para fins de reconstrução do LCA com enxerto ipsilateral dos tendões flexores da coxa no período de 6 de julho de 2000 a 19 de novembro de 2007. Resultados: 176 pacientes foram avaliados com média de 34,95 ± 18,8 meses (mediana 31 meses) (IIQ: 20-48 meses). A avaliação mínima foi aos 12 meses e a máxima aos 87 meses. Obtivemos 138 (78,4%) pacientes com resultado excelente, 22 (12,5%) com resultado bom, oito (4,5%) com resultado regular e oito (4,5%) pacientes apresentaram resultado ruim. Não foi considerada significativa a maior incidência de bons e excelentes resultados para o sexo masculino (p = 0,128), para os pacientes com IMC < 25 (p = 0,848) e para os pacientes sem a lesão do LCA relacionada a episódio inicial traumático com fratura no MI (p = 0,656). Conclusões: A técnica de reconstrução do LCA com o autoenxerto dos tendões flexores da coxa demonstrou bons e excelentes resultados em 91,4% da amostra. O sexo masculino parece apresentar tendência maior a bons e excelentes resultados. Não observou-se diferença estatisticamente significativa quando foram analisados os resultados com relação ao IMC e a associação com episódio inicial traumático de fratura no MI. descritores -

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Objective: To determine whether there was any discrepancy in elbow flexion strength among patients with and without evident clinical deformity resulting from arthroscopic tenotomy on the long head of the biceps. Method: A group of 120 patients who underwent this procedure were evaluated. After applying the exclusion criteria, 89 patients remained in the analysis. Eighteen months after the operation (median), the elbow flexion strength was measured in newtons using a digital dynamometer. Three consecutive measurements were made and the average was used. The dominant and non-dominant sides were compared. Sex, age and mean elbow flexion strength in the operated and contralateral arms of patients with and without apparent clinical deformity were evaluated. The authors declare that there was no conflict of interest in conducting this work This article is available online in Portuguese and English at the websites: www.rbo.org.br and www.scielo.br/rbort patients with evident clinical deformity was 17.78 N for the dominant arm and 20.87 N for the non-dominant arm. The difference was 2.51 N. In the group without evident clinical deformity, the difference was 2.14 N. The median muscle strength in the operated arm was 17.26 N, while the median was 20.06 N in the non-operated arm, thus suggesting that there was a significant loss of muscle strength (p = 0.005). The difference in muscle strength loss between the patients with and without evident deformity was not considered statistically significant (p = 0.977). Conclusion: The patients who underwent arthroscopic tenotomy on the long head of the biceps with or without apparent clinical deformity from distal migration presented similar elbow flexion muscle strength.

Objective: To determine whether there was any discrepancy in elbow flexion strength among patients with and without evident clinical deformity resulting from arthroscopic tenotomy on the long head of the biceps. Method: A group of 120 patients who underwent this procedure were evaluated. After applying the exclusion criteria, 89 patients remained in the analysis. Eighteen months after the operation (median), the elbow flexion strength was measured in newtons using a digital dynamometer. Three consecutive measurements were made and the average was used. The dominant and non-dominant sides were compared. Sex, age and mean elbow flexion strength in the operated and contralateral arms of patients with and without apparent clinical deformity were evaluated. Results: The median elbow flexion strength among the patients with evident clinical deformity was 17.78 N for the dominant arm and 20.87 N for the non-dominant arm. The difference was 2.51 N. In the group without evident clinical deformity, the difference was 2.14 N. The median muscle strength in the operated arm was 17.26 N, while the median was 20.06 N in the non-operated arm, thus suggesting that there was a significant loss of muscle strength (p = 0.005). The difference in muscle strength loss between the patients with and without evident deformity was not considered statistically significant (p = 0.977). Conclusion: The patients who underwent arthroscopic tenotomy on the long head of the biceps with or without apparent clinical deformity from distal migration presented similar elbow flexion muscle strength.