“Relaxed” Biceps Proximal Tenodesis: An Arthroscopic Technique With Decreased Residual Tendon Tension

Valenti, Philippe; Benedetto, Ivan; Maqdes, Ali; Lima, Sara; Moraiti, Constantina

doi:10.1016/j.eats.2014.07.005

Cited by 11 publications

(16 citation statements)

References 10 publications

(12 reference statements)

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“…For this reason, many advocate a more distal tenodesis, suprapectoral or even subpectoral. 7 , 13 , 18 , 27 , 28 , 30 , 37 , 51 , 56 , 61 Nevertheless, we agree with Denard et al, 8 who has shown that a better LHB tendon length-tension relation recovery can be obtained with an interference screw adjacent to the articular margin of the humerus in a 25-mm-deep hole. Maybe the persistence of pathologic tendon tissue in the bicipital groove and not the tension increase per se is what precipitates pain on palpation.…”

Section: Discussionsupporting

confidence: 90%

Intra-articular arthroscopic biceps tenodesis with interference screw: clinical and isokinetic evaluation

et al. 2020

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Background Although biceps tenodesis has been widely used to treat its pathologies, few studies looked at the objective evaluation of elbow strength after this procedure. The purpose of this study is to clinically evaluate patients submitted to long head of the biceps (LHB) tenodesis with interference screws through an intra-articular approach and analyze the results of an isokinetic test to measure elbow flexion and forearm supination strengths. Methods Patients who had biceps tenodesis were included in the study if they had a minimum follow-up of 24 months. Patients were excluded if they had concomitant irreparable cuff tears or previous or current contralateral shoulder pain or weakness. Postoperative evaluation was based on University of California–Los Angeles (UCLA) shoulder score and on measurements of elbow flexion and supination strength, using an isokinetic dynamometer. Tests were conducted in both arms, with velocity set at 60º/s with 5 concentric-concentric repetitions. Results Thirty-three patients were included and the most common concomitant diagnosis were rotator cuff tear (69%) and superior labrum anterior to posterior (SLAP) lesions (28%). The average UCLA score improved from 15.1 preoperatively to 31.9 in the final follow-up ( P < .001). Isokinetic tests showed no difference in peak torque between the upper limbs. One patient had residual pain in the biceps groove. None of the patients had Popeye deformity. UCLA score and follow-up length did not demonstrate correlation with peak torque. Conclusion Arthroscopic proximal biceps tenodesis with interference screw, close to the articular margin, yielded good clinical results. Isokinetic tests revealed no difference to the contralateral side in peak torque for both supination and elbow flexion.

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Section: Discussionsupporting

confidence: 90%

Intra-articular arthroscopic biceps tenodesis with interference screw: clinical and isokinetic evaluation

et al. 2020

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“…Many studies have mentioned the EBG [17,[25][26][27][28][29][30][31], but they did not de ne the EBG by rule and line. Many studies on tenodesis of the LBT valued a location 10 mm distal to the proximal EBG that anatomically lies superior to the pectoralis major tendon [25,26,30].…”

Section: Discussionmentioning

confidence: 99%

Definition, classification and morphometry of entrance of the bicipital groove and its associations with lesions of adjacent structures

Yuan

Zou

Zheng

et al. 2020

Preprint

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Background The definition of the entrance of the bicipital groove (EBG) is still unclear, and the relationships between the EBG and lesions of the long head of the biceps brachii tendon (LBT) and biceps pulley complex (BPC) have long been controversial. The purpose of this anatomic and imaging study was to define the EBG and to examine morphological parameters, classifications, and their relationships with lesions of the LBT and BPC. Methods One hundred thirteen unpaired intact dry humeri, 34 cadaveric shoulder specimens and 278 shoulder images were collected, measured, and classified based on morphological characteristics. Soft tissue and bony landmarks of the EBG were classified into different types. The relationships between the types and lesions of the LBT and BPC were analyzed through an anatomic and imaging study. Results Type II, type A and type i of the EBG and type b of the adjacent articular surface accounted for most of the dry humeri, cadavers, and images. Based on the EBG classification in the superoinferior image view, all of the subluxations and dislocations were classified as type B (61/120, 50.83%; χ2 = 16.55, P < 0.001), and most LBT and BPC lesions were type B (65/117, 55.56%; χ2 = 26.05, P < 0.001). LBTs were injured in (χ2=, P < 0.001) 83.56% of type B, 100% of type C, and 95.83% of type iii EBGs (χ2 = 135.69, 31.89, all P < 0.001). Similarly, BPCs were injured in 89.04% of type B and 93.10% of type C EBGs (χ2 = 153.14, P < 0.001), while BPCs were injured in 95.8% of type iii EBGs (χ2 = 33.79, P < 0.001). Conclusions The EBG is an anatomical concept worthy of clinical attention. Anatomical variations in the EBG correlated with lesions of the LBT and BPC. LBT and BPC lesions correlated with type B and C EBGs by imaging analysis.

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“…They found that this technique limited the risk of persistent tendon pathology and pain without a cosmetic deformity such as a Popeye sign. 15 This article presents a novel method in minimally invasive all-arthroscopic tenodesis by securing the proximal biceps tendon to the interference screw prior to fixation into the humerus. The benefits of the technique may avoid the tendon pullout from the screw-bone interface as described by Slabaugh et al 26 Although many techniques are used in practice and reported in the literature, it is certain that many young active patients with significant pathology will benefit from tenodesis.…”

Section: Discussionmentioning

confidence: 99%

“…They found that this technique limited the risk of persistent tendon pathology and pain without a cosmetic deformity such as a Popeye sign. 15…”

Section: Discussionmentioning

confidence: 99%

“…11,12 The location of the tenodesis has been debated regarding the upper portion of the bicipital groove or the distal subpectoral location. [13][14][15][16] The optimal location of the biceps tendon during a tenodesis is debatable in the literature. A biceps tenodesis helps prevent biceps pain and cramping during movement and helps avoid the cosmetic deformity with a biceps tenotomy.…”

Section: Introductionmentioning

confidence: 99%

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A technique for an arthroscopic proximal biceps tenodesis using a fork anchor

Amin

Volpi

Simons

et al. 2017

Journal of Orthopaedic Surgery

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Pathology to the proximal biceps tendon has the potential to be a major source of pain in the shoulder, secondary to complex superior labrum from anterior to posterior (SLAP) lesions, partial biceps tears, and subluxations. In order to restore function and improve the patient's quality of life, repair of these injuries is crucial. Tenodesis has long been the ideal treatment of persistent pain caused by pathology of the proximal biceps tendon. A biceps tenodesis helps prevent biceps pain and cramping during movement and avoids the cosmetic deformity associated with a biceps tenotomy. However, the location of the tenodesis and technique of the procedure itself have been debated throughout the literature. We present an arthroscopic biceps tenodesis technique in which the tendon is secured to the implant prior to implantation into the humerus to gain complete control of the tendon and ensure adequate fixation and tension.

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“Relaxed” Biceps Proximal Tenodesis: An Arthroscopic Technique With Decreased Residual Tendon Tension

Cited by 11 publications

References 10 publications

Intra-articular arthroscopic biceps tenodesis with interference screw: clinical and isokinetic evaluation

Intra-articular arthroscopic biceps tenodesis with interference screw: clinical and isokinetic evaluation

Definition, classification and morphometry of entrance of the bicipital groove and its associations with lesions of adjacent structures

A technique for an arthroscopic proximal biceps tenodesis using a fork anchor

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