Histomorphologic Changes of the Long Head of the Biceps Tendon in Common Shoulder Pathologies

Mazzocca, Augustus D.; McCarthy, Mary Beth; Ledgard, Felicia; Chowaniec, David M.; McKinnon, William; Delaronde, Steven; Rubino, L. Joseph; Apolostakos, John; Romeo, Anthony A.; Arciero, Robert A.; Beitzel, Knut

doi:10.1016/j.arthro.2013.02.002

Cited by 44 publications

(31 citation statements)

References 25 publications

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“…Patients with rotator cuff tears frequently develop long head of the biceps tendon pathology [2], which may lead to increasing pain and loss of function. Previous studies have demonstrated structural long head of the biceps tendon damage in the presence of cuff tears both clinically [13] and in a rat rotator cuff tear model [14]. Commonly, these long head of the biceps tendon symptoms persist and surgeons often will recommend arthroscopic tenodesis or tenotomy.…”

Section: Introductionmentioning

confidence: 99%

Biceps Detachment Decreases Joint Damage in a Rotator Cuff Tear Rat Model

Thomas

Reuther

Tucker

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Pathology in the long head of the biceps tendon often occurs in patients with rotator cuff tears. Arthroscopic tenotomy is the most common treatment. However, the role of the long head of the biceps at the shoulder and the consequences of surgical detachment on the remaining shoulder structures remain unknown. Questions/purposes We hypothesized that detachment of the long head of the biceps, in the presence of supraspinatus and infraspinatus tears, would decrease shoulder function and decrease mechanical and histologic properties of both the subscapularis tendon and the glenoid articular cartilage. Methods We detached the supraspinatus and infraspinatus or the supraspinatus, infraspinatus, and long head of the biceps after 4 weeks of overuse in a rat model. Animals were gradually returned to overuse activity after detachment. At 8 weeks, the subscapularis and glenoid cartilage biomechanical and histologic properties were evaluated and compared. Results The group with the supraspinatus, infraspinatus, and long head of the biceps detached had greater medial force and decreased change in propulsion, braking, and vertical force. This group also had an increased upper and lower subscapularis modulus but without any differences in glenoid cartilage modulus. Finally, this group had a significantly lower cell density in both the upper and lower subscapularis tendons, although cartilage histology was not different. Conclusions Detachment of the long head of the biceps tendon in the presence of a posterior-superior cuff tear resulted in improved shoulder function and less joint damage in this animal model. Clinical Relevance This study provides evidence in an animal model that supports the use of tenotomy for the management of long head of the biceps pathology in the presence of a two-tendon cuff tear. However, long-term clinical trials are required.

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Section: Introductionmentioning

confidence: 99%

Biceps Detachment Decreases Joint Damage in a Rotator Cuff Tear Rat Model

Thomas

Reuther

Tucker

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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“…8,20 In particular, zone 2 represents a ''no man's land'' because it remains hidden from arthroscopic view above and open subpectoral view below. Whereas some authors have begun to recognize the clinical relevance of the extra-articular bicipital tunnel, 9,13,20 the literature has overwhelmingly neglected zone 2 lesions in favor of more proximal disease, which is more readily visualized arthroscopically. 6,15,16 LHBT, long head of the biceps tendon.…”

Section: A Functional Bottleneck Occurs Between Zone 2 and Zone 3 (Limentioning

confidence: 98%

The anatomy and histology of the bicipital tunnel of the shoulder

Taylor

Fabricant

Bansal

et al. 2015

Journal of Shoulder and Elbow Surgery

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“…In addition to TB stain, proteoglycans are also evaluated with Alcian blue stain. Mazzocca et al . performed a morphological study investigating tendon pathology in which the positive Alcian blue staining was semi‐quantified with a computed topography system, and the results showed a significant increase in Alcian blue staining, indicating increased tendon degeneration.…”

Section: Optical Microscopymentioning

confidence: 99%

Optical Microscopy and Electron Microscopy for the Morphological Evaluation of Tendons: A Mini Review

Liu

Sun

et al. 2020

Orthopaedic Surgery

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The morphological characteristics of tendons have been thoroughly evaluated via microscopy. Optical microscopy and electron microscopy are the most commonly used techniques for tendon tissue observation. According to the principles of both microscopy types, preparation and evaluation methods vary. Simple optical microscopy is commonly used in the observation of cells and extracellular matrix, and many stains, including hematoxylin-eosin, Van Gieson, Prussian blue, Alcian blue, and toluidine blue, are used for evaluating cells, collagen fiber arrangement, and noncollagenous proteins. Histological scoring systems have been used in many studies for semi-quantification. Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) are the most commonly used electron microscopy types, and special consideration is needed for the fixation and embedding protocols. Glutaraldehyde followed by osmium is most commonly used in the chemical fixation of tendon tissue, followed by epoxy resin embedment. Longitudinal sections captured in SEM images show the arrangement of collagen fibrils and the cells and lipid drops among them, while cross sections captured in TEM images show the diameter and distribution of collagen fibrils. SEM and TEM are used together for comprehensive evaluations. This mini review is focused on the preparation methodology and related evaluation indexes for the morphological evaluation of tendons.

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Histomorphologic Changes of the Long Head of the Biceps Tendon in Common Shoulder Pathologies

Cited by 44 publications

References 25 publications

Biceps Detachment Decreases Joint Damage in a Rotator Cuff Tear Rat Model

Biceps Detachment Decreases Joint Damage in a Rotator Cuff Tear Rat Model

The anatomy and histology of the bicipital tunnel of the shoulder

Optical Microscopy and Electron Microscopy for the Morphological Evaluation of Tendons: A Mini Review

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