title: Direct biceps tendon and supraspinatus contact as an indicator of rotator cuff tear during shoulder arthroscopy in the lateral decubitus position.
abstract: The purpose of this study was to evaluate consecutive shoulder arthroscopies for the presence or absence of a space between the biceps tendon and the supraspinatus as an indicator of a full-thickness rotator cuff tear. We performed 588 consecutive shoulder arthroscopies in the lateral decubitus position, and the presence or absence of a space between the rotator cuff (supraspinatus) and the biceps tendon was recorded immediately upon entering and insufflating the joint. Of the 588 patients, 174 (30%) were found to have full-thickness rotator cuff tears. Of these 174 patients, 171 had absence of the space between the biceps and the supraspinatus, for a sensitivity of 98%. Of the 414 patients in whom no full-thickness tear was present, 4 had absence of the space, for a specificity of 99%. The 4 patients with a false-negative result had adhesive capsulitis. During shoulder arthroscopy, a normal interval exists between the supraspinatus and biceps tendons as a result of joint insufflation. Loss of this interval is both highly sensitive (98%) and specific (99%) for a full-thickness rotator cuff tear. The space between the rotator cuff and the biceps tendon can be a reliable adjunct for verification of a full-thickness rotator cuff tear immediately upon entering the shoulder joint but should not be used in place of a full arthroscopic evaluation of the cuff.
authors.affiliation: Kerlan-Jobe Orthopaedic Clinic, Los Angeles, CA, USA.
authors.forename: John D
authors.initials: JD
authors.lastname: Temple
authors.forename: Paul M
authors.initials: PM
authors.lastname: Sethi
authors.forename: F Daniel
authors.initials: FD
authors.lastname: Kharrazi
authors.forename: Neal S
authors.initials: NS
authors.lastname: Elattrache
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D015331:Cohort Studies; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology; D011237:Predictive Value of Tests; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012680:Sensitivity and Specificity; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000601:surgery; D013708:Tendon Injuries / Q000175:diagnosis* / Q000601:surgery