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Biceps Detachment Decreases Joint Damage in a Rotator Cuff Tear Rat Model

  • Symposium: Complex Issues in Glenohumeral Instability
  • Published:
Clinical Orthopaedics and Related Research®

An Erratum to this article was published on 11 July 2015

Abstract

Background

Pathology in the long head of the biceps tendon often occurs in patients with rotator cuff tears. Arthroscopic tenotomy is the most common treatment. However, the role of the long head of the biceps at the shoulder and the consequences of surgical detachment on the remaining shoulder structures remain unknown.

Questions/purposes

We hypothesized that detachment of the long head of the biceps, in the presence of supraspinatus and infraspinatus tears, would decrease shoulder function and decrease mechanical and histologic properties of both the subscapularis tendon and the glenoid articular cartilage.

Methods

We detached the supraspinatus and infraspinatus or the supraspinatus, infraspinatus, and long head of the biceps after 4 weeks of overuse in a rat model. Animals were gradually returned to overuse activity after detachment. At 8 weeks, the subscapularis and glenoid cartilage biomechanical and histologic properties were evaluated and compared.

Results

The group with the supraspinatus, infraspinatus, and long head of the biceps detached had greater medial force and decreased change in propulsion, braking, and vertical force. This group also had an increased upper and lower subscapularis modulus but without any differences in glenoid cartilage modulus. Finally, this group had a significantly lower cell density in both the upper and lower subscapularis tendons, although cartilage histology was not different.

Conclusions

Detachment of the long head of the biceps tendon in the presence of a posterior-superior cuff tear resulted in improved shoulder function and less joint damage in this animal model.

Clinical Relevance

This study provides evidence in an animal model that supports the use of tenotomy for the management of long head of the biceps pathology in the presence of a two-tendon cuff tear. However, long-term clinical trials are required.

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Acknowledgments

The authors thank Andrew Dunkman BS, Liz Feeney, Benjamin Freedman BS, and Corinne Riggin BS for their contribution to the overuse protocol. We also thank Rameen Vafa, George Fryhofer BS, and Alex Delong BS for their contribution to histology.

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Authors and Affiliations

  1. McKay Orthopaedic Research Laboratory, University of Pennsylvania, 424 Stemmler Hall, 36th Street and Hamilton Walk, Philadelphia, PA, 19104-6081, USA

    Stephen J. Thomas PhD, ATC, Katherine E. Reuther BS, Jennica J. Tucker BS, Joseph J. Sarver PhD, Sarah M. Yannascoli MD, Adam C. Caro DVM, Pramod B. Voleti MD, Sarah I. Rooney MSE, David L. Glaser MD & Louis J. Soslowsky PhD

Authors
  1. Stephen J. Thomas PhD, ATC
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  2. Katherine E. Reuther BS
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  3. Jennica J. Tucker BS
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  4. Joseph J. Sarver PhD
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  5. Sarah M. Yannascoli MD
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  6. Adam C. Caro DVM
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  7. Pramod B. Voleti MD
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  8. Sarah I. Rooney MSE
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  9. David L. Glaser MD
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  10. Louis J. Soslowsky PhD
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Corresponding author

Correspondence to Louis J. Soslowsky PhD.

Additional information

The institution of the authors received, during the study period, funding from NIH/NIAMS (Bethesda, MD, USA) (Grant R01AR056658) and the Penn Center for Musculoskeletal Disorders (Philadelphia, PA, USA) (NIH Grant P30 AR050950). Each author certifies that he or she, or a member of his or her immediate family, has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Each author certifies that his or her institution approved the animal protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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Thomas, S.J., Reuther, K.E., Tucker, J.J. et al. Biceps Detachment Decreases Joint Damage in a Rotator Cuff Tear Rat Model. Clin Orthop Relat Res 472, 2404–2412 (2014). https://doi.org/10.1007/s11999-013-3422-8

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  • DOI: https://doi.org/10.1007/s11999-013-3422-8

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