Hypertrophy of the extra-articular tendon of the long head of biceps correlates with the location and size of a rotator cuff tear

Takahashi, Norimasa; Sugaya, Hiroyuki; Matsuki, Keisuke; Miyauchi, Hikaru; Matsumoto, Momoko; Tokai, Morihito; Onishi, Kazutomo; Hoshika, Shota; Ueda, Yusuke

doi:10.1302/0301-620x.99b6.bjj-2016-0885.r1

Cited by 18 publications

(27 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…When compared with the single-stranded reconstruction, a V-shaped LHBT configuration allows for a more dynamic humeral head depression, thus possibly improving shoulder function. Additionally, the thickness 34 and the flatness 50 of the intra-articular LHBT may also contribute to the “spacer” effect described by Singh et al 49 Compared with commercially available allografts (thickness, 3.0 mm), which in contrast to the LHBT are most often flat, the LHBT used in this study was notably thicker (4.0-6.0 mm). This is comparable with the intact rotator cuff as well as the 6.0- and 8.0-mm thickness recommended by Scheiderer et al 47 and Mihata et al 39 to have the proposed spacer effect.…”

Section: Discussionmentioning

confidence: 70%

“…6,11,16,19,45,48 As the LHBT plays a dynamic role in contributing to glenohumeral stability and humeral head depression, especially in chronic rotator cuff tears, 23-25,27,46,50 SCR using a biologically viable LHBT autograft may be a feasible alternative, resulting in more favorable outcomes compared with SCR autografts because of biological advantages. 5,6,33,50 Additionally, the mechanical properties of the LHBT, such as ultimate strength, ultimate strain, and strain energy density, have been reported to be similar or even higher compared with that of other tendons around the shoulder joint, indicating that the LHBT has the ability to act as a humeral head depressor. 34 Thus, using an LHBT in these patients may be appealing, as it is locally available, free of additional costs, technically less demanding, and time-saving when compared with using allografts, xenografts, or synthetic patches.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Comparison of Different Fixation Techniques of the Long Head of the Biceps Tendon in Superior Capsule Reconstruction for Irreparable Posterosuperior Rotator Cuff Tears: A Dynamic Biomechanical Evaluation

et al. 2021

View full text Add to dashboard Cite

Background: In the past decade, superior capsular reconstruction has emerged as a potential surgical approach in young patients with irreparable posterosuperior rotator cuff tears (RCT) and absence of severe degenerative changes. Recently, the use of locally available and biological viable autografts, such as the long head of the biceps tendon (LHBT) for SCR has emerged, with promising early results. Purpose/Hypothesis: The purpose of this study was to investigate the effect of using the LHBT for reconstruction of the superior capsule on shoulder kinematics, along with different fixation constructs in a dynamic biomechanical model. The authors hypothesized that each of the 3 proposed fixation techniques would restore native joint kinematics, including glenohumeral superior translation (ghST), maximum abduction angle (MAA), maximum cumulative deltoid force (cDF), and subacromial peak contact pressure (sCP). Study Design: Controlled laboratory study. Methods: Eight fresh-frozen cadaveric shoulders (mean age, 53.4 ± 14.2 years) were tested using a dynamic shoulder simulator. Each specimen underwent the following 5 conditions: (1) intact, (2) irreparable posterosuperior rotator cuff tear (psRCT), (3) V-shaped LHBT reconstruction, (4) box-shaped LHBT reconstruction, and (5) single-stranded LHBT reconstruction. MAA, ghST, cDF and sCP were assessed in each tested condition. Results: Each of the 3 LHBT techniques for reconstruction of the superior capsule significantly increased MAA while significantly decreasing ghST and cDF compared with the psRCT ( P < .001 and P < .001, respectively). Additionally, the V-shaped and box-shaped techniques significantly decreased sCP ( P = .009 and P = .016, respectively) compared with the psRCT. The V-shaped technique further showed a significantly increased MAA ( P < .001, respectively) and decreased cDF ( P = .042 and P = .039, respectively) when compared with the box-shaped and single-stranded techniques, as well as a significantly decreased ghST ( P = .027) when compared with the box-shaped technique. Conclusion: In a dynamic biomechanical cadaveric model, using the LHBT for reconstruction of the superior capsule improved shoulder function by preventing superior humeral migration, decreasing deltoid forces and sCP. As such, the development of rotator cuff tear arthropathy in patients with irreparable psRCTs could potentially be delayed. Clinical Relevance: Using a biologically viable and locally available LHBT autograft is a cost-effective, potentially time-saving, and technically feasible alternative for reconstruction of the superior capsule, which may result in favorable outcomes in irreparable psRCTs. Moreover, each of the 3 techniques restored native shoulder biomechanics, which may help improve shoulder function by preventing superior humeral head migration and the development of rotator cuff tear arthropathy in young patients with irreparable rotator cuff tears.

show abstract

Section: Discussionmentioning

confidence: 70%

mentioning

confidence: 99%

Comparison of Different Fixation Techniques of the Long Head of the Biceps Tendon in Superior Capsule Reconstruction for Irreparable Posterosuperior Rotator Cuff Tears: A Dynamic Biomechanical Evaluation

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Evidence suggests that increased rotator cuff tear size may be associated with worse biceps tendon pathology. 10,30 Even though cuff tear size was not assessed in our study—which could theoretically affect tendon quality and explain outcome differences between the inlay and onlay groups—a clinical association between tear size and tenodesis healing has not yet been demonstrated. Moreover, the unique use of one technique during the first year and another during the second partially controls for selection bias, including differences in tear sizes between groups.…”

Section: Discussionmentioning

confidence: 87%

“…Pathologies of the long head of the biceps tendon are a common cause of anterior shoulder pain and can present in the form of inflammation, tearing, or instability. They are commonly associated with rotator cuff tears, 4,16,17,30 and patients who undergo concomitant management of these lesions have been shown to experience greater improvement in outcomes than those who undergo rotator cuff repair alone. 31…”

mentioning

confidence: 99%

Arthroscopic Biceps Tenodesis Outcomes: A Comparison of Inlay and Onlay Techniques

Haidamous¹,

Noyes²,

Denard

2020

Am J Sports Med

View full text Add to dashboard Cite

Background: Arthroscopic biceps tenodesis (ABT) high in the groove can be achieved using an inlay or an onlay technique. However, there is little information comparing outcomes between the 2. Purpose: To compare postoperative healing and functional outcomes of ABT high in the groove performed using either an onlay or an inlay technique. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective study was performed on patients undergoing ABT at the articular margin (high in the groove) at a single center over a 2-year period. An inlay technique using an interference screw was performed during the first year, followed by an onlay technique using a knotless suture anchor during the second. Tendon healing, elbow flexion strength, functional outcome, and complications were evaluated at a postoperative minimum of 1 year. Results: A total of 37 patients with inlay and 53 with onlay ABTs were available for follow-up. There was no difference in range of motion, functional outcome scores, or elbow flexion strength between the groups. A postoperative popeye deformity was noted in 27% of patients in the inlay group as compared with 9.4% of the onlay group ( P = .028). Four patients (10.8%) in the inlay group required revision surgery (2 of which were biceps tenodesis related) as compared with 0% in the onlay group ( P = .015). Conclusion: An onlay technique using a knotless suture anchor for ABT at the top of the articular margin is an acceptable alternative to an inlay technique using an interference screw. The onlay technique was associated with lower rates of postoperative popeye deformity and revision surgery as compared with the inlay technique.

show abstract

“…5 Despite significant recent progress in the development of RC repair techniques, failure rates after RC repair still remain highly variable mainly due to biological variability of the torn RC tendon and muscle with associated fatty atrophy. 6-8 Histological studies have shown that tendon does not heal by rebuilding a normal fibrocartilage enthesis but by forming scar tissue with a high content of type III collagen. 9,10 Therefore, TDSCs might be capable of promoting repair in the tendon bone junction and may influence the tendon structure after RC repair.…”

Section: Introductionmentioning

confidence: 99%

Tendon-derived stem cells from the long head of the biceps tendon

Schmalzl

Plumhoff

Gilbert

et al. 2019

Bone & Joint Research

View full text Add to dashboard Cite

Objectives The long head of the biceps (LHB) is often resected in shoulder surgery and could therefore serve as a cell source for tissue engineering approaches in the shoulder. However, whether it represents a suitable cell source for regenerative approaches, both in the inflamed and non-inflamed states, remains unclear. In the present study, inflamed and native human LHBs were comparatively characterized for features of regeneration. Methods In total, 22 resected LHB tendons were classified into inflamed samples (n = 11) and non-inflamed samples (n = 11). Proliferation potential and specific marker gene expression of primary LHB-derived cell cultures were analyzed. Multipotentiality, including osteogenic, adipogenic, chondrogenic, and tenogenic differentiation potential of both groups were compared under respective lineage-specific culture conditions. Results Inflammation does not seem to affect the proliferation rate of the isolated tendon-derived stem cells (TDSCs) and the tenogenic marker gene expression. Cells from both groups showed an equivalent osteogenic, adipogenic, chondrogenic and tenogenic differentiation potential in histology and real-time polymerase chain reaction (RT-PCR) analysis. Conclusion These results suggest that the LHB tendon might be a suitable cell source for regenerative approaches, both in inflamed and non-inflamed states. The LHB with and without tendinitis has been characterized as a novel source of TDSCs, which might facilitate treatment of degeneration and induction of regeneration in shoulder surgery. Cite this article: J. Schmalzl, P. Plumhoff, F. Gilbert, F. Gohlke, C. Konrads, U. Brunner, F. Jakob, R. Ebert, A. F. Steinert. Tendon-derived stem cells from the long head of the biceps tendon: Inflammation does not affect the regenerative potential. Bone Joint Res 2019;8:414–424. DOI: 10.1302/2046-3758.89.BJR-2018-0214.R2.

show abstract

Hypertrophy of the extra-articular tendon of the long head of biceps correlates with the location and size of a rotator cuff tear

Abstract: Regardless of the symptoms, there was significant hypertrophy of the extra-articular LHB tendon in patients with a rotator cuff tear. The values were significantly related to the size of the tear. Cite this article: 2017;99-B:806-11.

Cited by 18 publications

References 32 publications

Comparison of Different Fixation Techniques of the Long Head of the Biceps Tendon in Superior Capsule Reconstruction for Irreparable Posterosuperior Rotator Cuff Tears: A Dynamic Biomechanical Evaluation

Comparison of Different Fixation Techniques of the Long Head of the Biceps Tendon in Superior Capsule Reconstruction for Irreparable Posterosuperior Rotator Cuff Tears: A Dynamic Biomechanical Evaluation

Arthroscopic Biceps Tenodesis Outcomes: A Comparison of Inlay and Onlay Techniques

Tendon-derived stem cells from the long head of the biceps tendon

Contact Info

Product

Resources

About