Biceps tenodesis associated with arthroscopic repair of rotator cuff tears.
Associated lesions of the biceps tendon are commonly found during arthroscopic repair of rotator cuff tears. These lesions are treated with tenodesis, classically performed through an open approach. However, it seems reasonable to seek a single approach to correct both lesions; therefore, we have proposed a new arthroscopic technique that allows an exclusive arthroscopic tenodesis by including the biceps tendon in the rotator cuff suture, a surgical technique with a single suture of the rotator cuff that includes the biceps tendon. We treated 97 shoulders in 96 patients arthroscopically for complete rotator cuff tears. Of these shoulders, 15 required tenodesis for treatment of biceps tendon lesions. Through an arthroscopic approach, a subacromial decompression followed by a rotator cuff repair was carried out in association with a biceps tenodesis. In this technique, one limb of the suture was passed through the biceps tendon, and the other was passed through the rotator cuff tear, bringing both tissues together in the final suture. Of the patients, 9 were men and 5 were women. Their mean age was 71 years (range, 41-80 years). The dominant arm was affected in all patients. Postoperative evaluation, by use of the UCLA score, after a mean follow-up period of 32.4 months showed satisfactory results in 93.4% of patients: 11 had excellent results, 3 had good results, and only 1 had an unsatisfactory result. In this case a postoperative magnetic resonance imaging scan showed an intact rotator cuff and biceps tenodesis. The suture involving the rotator cuff and the biceps tendon proved effective to correct both lesions, with the main advantage being that an additional approach was not required.
Checchia
Sergio L
SL
Orthopedic Department, Santa Casa Hospitals and School of Medicine, São Paulo, Brazil. ombro@uol.com.br
Doneux
Pedro S
PS
Miyazaki
Alberto N
AN
Silva
Luciana A
LA
Fregoneze
Marcelo
M
Ossada
Andréa
A
Tsutida
Carlos Y
CY
Masiole
Cássio
C
D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D000070636:Rotator Cuff Injuries; D012421:Rupture; D012785:Shoulder Joint / Q000503:physiopathology; D013536:Suture Techniques; D013708:Tendon Injuries / Q000453:epidemiology / Q000601:surgery*; D016896:Treatment Outcome