The role of the long head of the biceps in subacromial impingement syndrome and arthroscopic assisted tenodesis

Ata ATALAR; Mehmet DEMİRHAN; Mustafa UYSAL

Article Details

The role of the long head of the biceps in subacromial impingement syndrome and arthroscopic assisted tenodesis

Authors:

Ata ATALAR | Mehmet DEMİRHAN | Mustafa UYSAL

Publisher:

Turkish Association of Orthopaedics and Traumatology

Journal:

Acta Orthopaedica et Traumatologica Turcica 2002 Vol.36 Issue 5, pp.408-412

Document Type:

Article

Publication Date:

9/2006

Document Language:

English

Document ID (Org No.):

2000813183

Frequency:

Bimonthly

eISSN:

1017-995X

pISSN:

1017-995X

Keywords:

Arthroscopy;Arthroscopy/methods;pain;pain/surgery;rotator cuff;rotator cuff/ pathology;rotator cuff/injuries;rotator cuff/surgery;shoulder impingement syndrome;shoulder impingement syndrome/pathology;shoulder impingement syndrome/surgery;shoulder joint;s

Abstract:

 

Objectives: Tenosynovitis of the long head of the biceps tendon, which commonly accompanies subacromial impingement syndrome, is one of the most important underlying cause of shoulder pain. We evaluated our experience with arthroscopic subacromial decompression and tenodesis of the long head of the biceps using mini-open approach. Methods: Among patients who underwent arthroscopic subacromial decompression (112 patients) alone or in combination with mini-open rotator cuff repair (55 patients), 19 patients (11%; 12 females, 7 males; mean age 47 years, range 42 to 62 years) had tenodesis of the long head of the biceps. During arthroscopy of the glenohumeral joint, the decision for tenodesis was based on the presence of irreversible findings of chronic inflammation such as atrophy, excessive fraying, or partial rupture. The patients were divided into two groups depending on the surgery, namely, mini-open rotator cuff repair (group 1, 9 patients) and arthroscopic subacromial decompression alone (group 2, 10 patients). The mean follow-up was 17.6 months in group 1 (range 12 to 28 months), and 19.6 months in group 2 (range 12 to 40 months). Results: Seven patients in group 1 (78%) did not complain about pain, while two patients had pain after vigorous physical activity. In group 2, nine patients (90%) were pain-free, whereas one patient had moderate pain. None of the patients had any cosmetic deformity. Two patients in group 1, and one patient in group 2 had mild biceps spasms.
Conclusion: Despite the small sample size and a relatively short follow-up period, our results for tenodesis may be regarded as satisfactory. Special attention should be paid to the arthroscopic evaluation of the biceps tendon and tenodesis may be inevitable in the presence of chronic changes.

 

Amaç: Genellikle subakromiyal sıkışma sendromu ile birlikte görülen biseps uzun başının tendiniti, omuz ağrısının önemli nedenlerinden biridir. Bu çalışmada, artroskopik subakromiyal dekompresyon ve biseps tendiniti nedeniyle mini-açık tenodez uyguladığımız olguları değerlendirdik. 
Çalışma planı: Artroskopik subakromiyal dekompresyon (112 hasta) ve artroskopik subakromiyal dekompresyon ile mini-açık rotator manşet tamiri (55 hasta) yapılan toplam 167 hastanın, biseps tenodezi uygulanan 19’u (%11; 12 kadın, 7 erkek; ort. yaş 47, dağılım 42-62) değerlendirmeye alındı. Glenohumeral eklem artroskopisi sırasında bisepste kronik enflamasyona bağlı atrofi, aşırı saçaklanma, kısmi yırtık gibi geri dönüşümsüz bulgular saptandığında, biseps tenodezi yapılmasına karar verildi. Hastalar, mini açık rotator manşet tamiri yapılanlar (grup 1, 9 hasta) ve yalnızca artroskopik subakromiyal dekompresyon uygulananlar (grup 2, 10 hasta) olarak iki gruba ayrıldı. Ortalama izlem süresi grup 1’de 17.6 ay (dağılım 12-28 ay), grup 2’de 19.6 ay (dağılım 12-40 ay) idi. Sonuçlar: Grup 1’de yedi hastada (%78) ağrı görülmedi; iki hastada ise ağır aktiviteler ile ortaya çıkıyordu. Grup 2’de dokuz hastada (%90) ağrı görülmezken; bir hastada orta derecede saptandı. Hiçbir hastada kozmetik deformite gözlenmedi. Grup 1’de iki, grup 2’de ise bir hastada hafif biseps spazmları vardı. Çıkarımlar: Olgu sayısının görece azlığına ve takip süresinin kısalığına karşın, biseps tenodezinden tatmin edici sonuç elde edildi. Tendonun artroskopik değerlendirmesine önem verilmeli ve gerekli durumlarda biseps tenodezine başvurmaktan çekinilmemelidir.

Article Details

The role of the long head of the biceps in subacromial impingement syndrome and arthroscopic assisted tenodesis

Authors: Ata ATALAR | Mehmet DEMİRHAN | Mustafa UYSAL

Publisher: Turkish Association of Orthopaedics and Traumatology

Journal: Acta Orthopaedica et Traumatologica Turcica 2002 Vol.36 Issue 5, pp.408-412

Document Type: Article

Publication Date: 9/2006

Document Language: English

Document ID (Org No.): 2000813183

Frequency: Bimonthly

eISSN: 1017-995X

pISSN: 1017-995X

Arthroscopy;Arthroscopy/methods;pain;pain/surgery;rotator cuff;rotator cuff/ pathology;rotator cuff/injuries;rotator cuff/surgery;shoulder impingement syndrome;shoulder impingement syndrome/pathology;shoulder impingement syndrome/surgery;shoulder joint;s

Issues

Authors:

Ata ATALAR | Mehmet DEMİRHAN | Mustafa UYSAL

Publisher:

Turkish Association of Orthopaedics and Traumatology

Journal:

Acta Orthopaedica et Traumatologica Turcica 2002 Vol.36 Issue 5, pp.408-412

Document Type:

Article

Publication Date:

9/2006

Document Language:

English

Document ID (Org No.):

2000813183

Frequency:

Bimonthly

eISSN:

1017-995X

pISSN:

1017-995X