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Reparable rotator cuff tears with concomitant long-head biceps lesions: tenotomy or tenotomy/tenodesis?

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The aim of the study was to determine clinical, functional, and radiological results of two groups of patients affected by rotator cuff tear with concomitant degeneration of the long head of the biceps tendon treated with tenotomy/tenodesis or tenotomy.

Methods

Sixty-five patients were randomly assigned to group A (35 patients, tenotomy/tenodesis) and group B (30 patients, tenotomy). All patients underwent physical examination and simple shoulder test and Constant score scales. Moreover, they underwent dynamometric tests and power Doppler ultrasonography in order to evaluate the exact location of the long-head biceps and the vascularization of the repaired rotator cuff and of the long-head biceps.

Results

Physical examination and clinical evaluation scales showed satisfactory results in both groups, with no significant differences (n.s.). Popeye sign was detected in 5 patients (17%) of group B and in no one patient of group A. Ultrasound examination showed the LHB within the bicipital groove in 80% of group A and group B. Power Doppler ultrasonography showed signs of vascularization of the LHB in 20% of patients of group A and in 40% of group B and signs of vascularization of the repaired rotator cuff in 28% of group A and 40% of group B.

Conclusions

Long head of the biceps tenotomy combined with tenodesis does not provide any significant clinical or functional improvement than isolated tenotomy. However, the incidence of the Popeye sign is significantly higher, even though not associated with any functional disfunction.

Level of evidence

Therapeutic study, Level II.

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Acknowledgments

The authors thank Dr. Gianluca Mastrantonio for the statistical analysis and Mrs. Angela Mitchell for technical support during the study.

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Authors and Affiliations

  1. Orthopaedic and Traumatology Department, S. Andrea Hospital, University of Rome “La Sapienza”, Rome, Italy

    Angelo De Carli, Antonio Vadalà, Edoardo Zanzotto, Guido Zampar, Mario Vetrano, Raffaele Iorio & Andrea Ferretti

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  1. Angelo De Carli
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  2. Antonio Vadalà
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  3. Edoardo Zanzotto
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  4. Guido Zampar
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  5. Mario Vetrano
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  6. Raffaele Iorio
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  7. Andrea Ferretti
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Correspondence to Antonio Vadalà.

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De Carli, A., Vadalà, A., Zanzotto, E. et al. Reparable rotator cuff tears with concomitant long-head biceps lesions: tenotomy or tenotomy/tenodesis?. Knee Surg Sports Traumatol Arthrosc 20, 2553–2558 (2012). https://doi.org/10.1007/s00167-012-1918-5

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  • DOI: https://doi.org/10.1007/s00167-012-1918-5

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