Stabilization of the Long Head of the Biceps Tendon in the Context of Early Repair of Traumatic Subscapularis Tendon Tears

Maier, Dirk; Jaeger, Martin; Suedkamp, Norbert P.; Koestler, Wolfgang
August 2007
Journal of Bone & Joint Surgery, American Volume;Aug2007, Vol. 89-A Issue 8, p1763
Academic Journal
Background: Tears of the subscapularis tendon commonly are associated with instability of the long head of the biceps tendon. Standard surgical treatment includes tenodesis or tenotomy of the biceps tendon. However, chronic discomfort from spasms and cosmetic disadvantages have been reported following both procedures, while the potential for functional impairments remains controversial. We investigated the outcome of stabilization of the long head of the biceps tendon in the context of early repair of traumatic tears of the subscapularis tendon. Methods: We performed stabilization of an unstable, structurally intact long head of the biceps tendon in twenty-one patients in the acute phase after a traumatic tear of the subscapularis tendon. The average period from the injury to the surgery was 6.2 weeks. Open tendon stabilization and subscapularis reconstruction were performed with transosseous sutures. The follow-up consisted of clinical examination (with determination of the absolute, age and gender-related, and individual relative Constant scores; clinical evaluation of the long head of the biceps; and subjective determination of shoulder function) and dynamic ultrasound examination. Results: The average follow-up period was 28.4 months. The mean absolute Constant score increased from 26.3 points preoperatively to 79.3 points postoperatively (p < 0.01). The mean age and gender-related Constant score improved from 28.0% to 87.0% (p < 0.01). Seven patients showed clinical symptoms consistent with mild biceps tendinopathy. Using dynamic ultrasound examination, we found two cases of recurrent instability (medial subluxation) of the long head of the biceps tendon. Secondary rupture of the long head of the biceps tendon occurred in one patient, twenty-six months after the surgery. Conclusions: The functional outcomes of stabilization of the long head of the biceps tendon in the context of early repair of a traumatic tear of the subscapularis tendon were comparable with the results of tenodesis or tenotomy reported in previous studies. The cosmetic results were superior, and chronic discomfort from spasms was not observed. Stabilization of the tendon of the long head of the biceps can be recommended as a treatment option for selected patients and should be discussed as an alternative to tenodesis or tenotomy, particularly in a young patient. Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.


Related Articles

  • Seizure outcome with surgical management of epileptogenic ganglioglioma: a study of 55 patients. Hu, Wen-han; Ge, Ming; Zhang, Kai; Meng, Fan-gang; Zhang, Jian-guo // Acta Neurochirurgica;May2012, Vol. 154 Issue 5, p855 

    Background: Ganglioglioma is a common seizure-associated tumor, and some factors that may influence the postoperative seizure outcome have not been discussed or are controversial. The goal of this study was to observe the postoperative seizure outcome and the prognostic factors in patients with...


    Increasing in electromechanical delay has been found in patients after ACL reconstruction using both semitendinosus and gracilis tendons. Using only one tendon may improve electromechanical delay results in patients after ACL reconstruction surgery. The purpose of the study is to evaluate...

  • Surgical repair of the distal biceps brachii tendon: a comparative study of three surgical fixation techniques. Citak, Mustafa; Backhaus, Manuel; Seybold, Dominik; Suero, Eduardo; Schildhauer, Thomas; Roetman, Bernd // Knee Surgery, Sports Traumatology, Arthroscopy;Nov2011, Vol. 19 Issue 11, p1936 

    Purpose: Several fixation techniques exist to repair the distal biceps brachii tendon. We aimed to evaluate the clinical and functional outcomes after distal biceps tendon repair using three different fixation techniques. Methods: A total of 54 patients were included in the study and were...

  • Nueva técnica de osteotomía tibial para el tratamiento del recurvatum en la rodilla paral&iaacute;tica. Procedimientos y técnicas en ortopedia. Zamudio, Leonardo; Hernández, Gustavo; Hernández, Cristina; Macías, Juana Del Socorro // Acta Ortopedica Mexicana;ene/feb2004, Vol. 18 Issue 1, p29 

    A new technic for the treatment of paralytic genu recurvatum is presented. It includes a high tibia osteotomy very closed to the articular surface. For approaching the site, the removal of a large fragment of cortical bone of the anterior aspect of the tibia is required including the insertion...

  • Probleme bei komplexen Rückfußkorrekturen. Volkering, C.; Erne, H.; Altenberger, S.; Walther, M. // Der Orthopäde;May2011, Vol. 40 Issue 5, p415 

    This article discusses the intraoperative and postoperative problems seen in the treatment of posterior tibial tendon dysfunction. Problems associated with tendon transposition procedures, osteotomy and arthrodesis are discussed. The preoperative, intraoperative and postoperative problems and...

  • Does initial Pirani score and age influence number of Ponseti casts in children? Agarwal, Anil; Gupta, Neeraj // International Orthopaedics;Mar2014, Vol. 38 Issue 3, p569 

    Purpose: The prediction of number of casts in the Ponseti method has always remained a subject of interest. We investigated the correlation of the number of casts before tenotomy with the age and initial Pirani score in Ponseti treatment of club foot. Methods: Inclusion criteria were idiopathic...

  • What's New in Sports Medicine. Starman, James S.; Griffin, Justin W.; Kandil, Abdurrahman; Ma, Richard; Hogan, MaCalus V.; Miller, Mark D. // Journal of Bone & Joint Surgery, American Volume;4/16/2014, Vol. 96 Issue 8, p695 

    The article focuses on the latest developments from the sports medicine. It discusses the natural history of rotator cuff disease, rotator cuff repair and role of hip arthroscopy. It also discusses Superior Labrum Anterior and Posterior (SLAP) Repair versus Biceps Tenotomy. It also reports on...

  • Hepatectomía laparoscópica. NICOLÁS JARUFE, C.; ANDRÉS MARAMBIO, G.; JUAN FRANCISCO DE LA LLERA, K.; JULIÁN VARAS, C.; MARCEL SANHUEZA, G.; JORGE MARTÍNEZ, C. // Revista Chilena de Cirugia;Oct2013, Vol. 65 Issue 5, p463 

    The surgical technique employed in laparoscopic liver resection is characterized by its great complexity. It is also associated to a long learning curve, which determines that this procedure is only completed in certain reference centers by few highly trained surgeons. Other challenges related...

  • Avoidance of unfavourable results following primary flexor tendon surgery. Elliot, D.; Giesen, T. // Indian Journal of Plastic Surgery;May-Aug2013, Vol. 46 Issue 2, p312 

    This review describes the biological problems faced by those managing primary flexor tendon injuries and explains why these problems still thwart attempts to achieve normal, or near normal, function after this injury, despite a century of surgical effort. It considers the historical background...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics