Imaging the long head of biceps tendon--a pictorial essay emphasizing magnetic resonance.

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Abstract

[Indexed for MEDLINE] 20. J Orthop Surg Res. 2023 Aug 16;18(1):603. doi: 10.1186/s13018-023-04078-9. Modified arthroscopic intra-articular transtendinous looped biceps tenodesis leads to satisfactory functional outcomes and less frequent Popeye deformity compared to biceps tenotomy. Chiang CH(1), Ho W(1), Lin CH(1), Chih WH(1), Su WR(2)(3)(4), Hong CK(5)(6). Author information: (1)Department of Orthopaedics, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan. (2)Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng-Li Road, North Dist., Tainan, 70428, Taiwan. (3)Skeleton Materials and Bio-Compatibility Core Lab, Research Center of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. (4)Musculoskeletal Research Center, Innovation Headquarter, National Cheng Kung University, Tainan, Taiwan. (5)Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng-Li Road, North Dist., Tainan, 70428, Taiwan. yayahong@gmail.com. (6)Department of Orthopaedic Surgery, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan. yayahong@gmail.com. PURPOSE: The present study aimed to propose a modified intra-articular transtendinous looped biceps tenodesis (mTLBT) using a suture anchor and to compare the functional outcomes and incidence of Popeye deformities between biceps tenotomy and mTLBT. METHODS: Medical records of patients who underwent either tenotomy or mTLBT for the long head of the biceps tendon (LHBT) lesion between January 2016 and April 2021 were retrospectively reviewed. The inclusion criteria were patients aged 40-70 years with LHBT pathologies, such as superior labrum anterior to posterior (SLAP) lesions > type II, LHBT pulley system rupture with bicipital instability, and intra-articular LHBT tear. The exclusion criteria were full-thickness supraspinatus tears, frozen shoulder, shoulder fracture, and postoperative traumatic events that affected the operated shoulder. All patients were followed up for at least 1 year. Popeye deformity, bicipital cramping pain, visual analog scale (VAS) pain score, and functional outcome scores (University of California at Los Angeles [UCLA] and American Shoulder and Elbow Surgeons [ASES] scores) were recorded. Fisher's exact test and Chi-square test were used for categorical variables, whereas the Mann-Whitney U test was used for nonparametric variables. RESULTS: The mTLBT and tenotomy groups included 15 and 40 patients, respectively. The incidence of Popeye deformity and biceps cramping pain in the tenotomy group (52.5% and 50%, respectively) was significantly higher than that in the mTLBT group (13.3% and 20%, respectively) (p = 0.009 and p = 0.045, respectively). The postoperative VAS, UCLA, and ASES scores were not significantly different between the two groups. One patient in the tenodesis group experienced metallic-anchor pullout. CONCLUSION: mTLBT is an arthroscopic intra-articular top of the groove tenodesis that can be performed completely in the intra-articular space and is especially suitable for patients with an intact or partially torn rotator cuff. This technique is reliable for treating biceps pathologies as it results in similar functional outcome scores, lesser biceps cramping pain, and less frequent Popeye deformity compared to biceps tenotomy. LEVEL OF EVIDENCE: III. © 2023. BioMed Central Ltd., part of Springer Nature. DOI: 10.1186/s13018-023-04078-9 PMCID: PMC10428633