Using Biceps Tendon Autograft as a Patch in the Treatment of Massive Irreparable Rotator Cuff Tears Improves Patient-reported Outcome Scores: A Systematic Review

Cheppalli, Naga Suresh; Purudappa, Prabhudev Prasad; Metikala, Sreenivasulu; Goel, Akshay; Singla, Amit; Sambandam, Senthil

doi:10.1016/j.asmr.2023.01.016

Cited by 4 publications

(5 citation statements)

References 12 publications

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“…In addition to the superior capsular reconstruction (SCR) with the long head of the biceps tendon (LHBT), we performed a tension-free double-row repair of the supraspinatus and of the subescapularis if it is also injured. As other authors have published 14 , 15 , 16 and as is also our experience, by reinforcing the cuff suture using the long head of the biceps, we improve both the biomechanics and the biology of the repair and decrease the rate of retears.…”

Section: Introductionsupporting

confidence: 66%

“…The SCR with the LHBT is really a booster for the supraspinatus repair, both from the biomechanical and biological point of view; we create a superior static stabilizer, to try to reduce the rate of cuff retears and achieve a better clinical progression that lasts over time. 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 We follow the Mihata technique also for the fixation of the LHBT at the greater tuberosity in 30° of abduction, which is the optimal position for graft fixation and tension. 22 , 23 …”

Section: Discussionmentioning

confidence: 99%

“…We might think that this technique could produce postoperative pain associated with the use of the LHBT, since it is a pain generator, but in our experience, which coincides with other authors’ experiences, this is not a real problem that appears. 12 , 13 , 14 , 15 , 16 , 17 , 18 , 30 There are risks associated with LHB tenotomy, such as the appearance of Popeye’s sign or cramps, although over time, they rarely represent a functional problem in patients. 27 , 28 …”

Section: Discussionmentioning

confidence: 99%

“…Some authors have used this technique in irreparable massive tears as an isolated technique, or combined with partial repairs of the rotator cuff. 12 , 13 , 14 , 15 , 16 …”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Arthroscopic Superior Capsular Reconstruction With the Long Head of the Biceps Tendon to Reinforce the Repair of a Supraspinatus Tear and Increase Healing

Cañete San Pastor,

Prosper Ramos,

Garcia Roig

2023

Arthroscopy Techniques

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Section: Introductionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Some authors have used this technique in irreparable massive tears as an isolated technique, or combined with partial repairs of the rotator cuff. 12 , 13 , 14 , 15 , 16 …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Arthroscopic Superior Capsular Reconstruction With the Long Head of the Biceps Tendon to Reinforce the Repair of a Supraspinatus Tear and Increase Healing

Cañete San Pastor,

Prosper Ramos,

Garcia Roig

2023

Arthroscopy Techniques

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“…Although 24% to 74% successful healing rates have been reported in massive rotator cuff tears, there is a high incidence of retears and incomplete healing. 7 With the recent technical advances, most of the massive rotator cuff tears are managed successfully. Due to the degenerative nature of the tears and their propensity to heal incompletely, grafting or augmentation of repair is desirable.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Double-Row Rotator Cuff Repair With Biceps Augmentation

Mundakkal,

Panakkal,

Nair

et al. 2024

Arthroscopy Techniques

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Long head of biceps tendon augmentation for massive rotator cuff tears improves clinical results regardless of the number of tendons involved

Savarese,

Aicale,

Torsiello

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeManagement of massive rotator cuff tears (MRCTs) remains debated, and various arthroscopic and open techniques have been described for their management. Nevertheless, the optimal strategy remains unclear. The present study evaluated the clinical results in patients managed arthroscopically for MRCTs augmented with the long head biceps tendon (LHBT) at a minimum 1‐year follow‐up, considering different type of tears, demographic data and number of torn tendons.MethodsPatients treated in a secondary referral centre from January 2021 to April 2022 were enroled prospectively. Inclusion criteria were pain, inability to fully elevate the affected shoulder, irreparable tears and active and motivated patients. All patients were managed within 2 months from diagnosis in a single centre by the same surgeons. Preoperative shoulder radiographs and magnetic resonance imaging (MRI) were collected, and clinical assessment was also performed using the Numerical analogue scale (NAS), Constant score (CS) American Shoulder and Elbow Surgeons Shoulder Score (ASES). Tissue retraction and tendon fatty infiltration were evaluated using Patte and Fuchs scale, respectively. Clinical assessment was performed using the same scales at 3–6 months and 1‐year follow‐up.ResultsA total of 55 patients (31 female and 24 male) with a mean age of 60 ± 7.1 years were enroled for a mean follow‐up of 18.2 ± 4.3 months. The mean preoperative NAS was 7.8 ± 0.6, CS was 20.5 ± 7.6 and ASES was 22.6 ± 9.2, increasing, respectively, to 0.3 ± 0.6, 91.5 ± 6.9 and 94.2 ± 6.7. No adverse side effects (infection, rejection, allergy) were reported during the study period. All patients were evaluated after surgery at 3 and 6 months and 1 year with statistically significant improvement for each score at the first and last follow‐up (p < 0.05).ConclusionsThe use of LHBT augmentation in patients with MRCTs in appropriately selected patients is safe and effective and can lead to pain relief and acceptable clinical outcomes. Furthermore, its use carries low donor site morbidity and is cost effective. Comparative studies, including randomised controlled trials, with other proposed techniques are needed to confirm these findings.Level of EvidenceLevel IV.

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Using Biceps Tendon Autograft as a Patch in the Treatment of Massive Irreparable Rotator Cuff Tears Improves Patient-reported Outcome Scores: A Systematic Review

Cited by 4 publications

References 12 publications

Arthroscopic Superior Capsular Reconstruction With the Long Head of the Biceps Tendon to Reinforce the Repair of a Supraspinatus Tear and Increase Healing

Arthroscopic Superior Capsular Reconstruction With the Long Head of the Biceps Tendon to Reinforce the Repair of a Supraspinatus Tear and Increase Healing

Arthroscopic Double-Row Rotator Cuff Repair With Biceps Augmentation

Long head of biceps tendon augmentation for massive rotator cuff tears improves clinical results regardless of the number of tendons involved

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