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Rupture of the long head biceps tendon treated with tenodesis to the coracoid process. Results at more than 30 years

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Abstract

We evaluated patients at very long term with rupture of the long head biceps tendon (LHBT) in whom the tendon stump had been sutured to the coracoid tip (Gilcreest technique). Our aim was to determine the natural history of shoulders deprived of the LHBT and to assess the validity of the surgical technique. Between 1969 and 1981, 30 patients with rupture of the LHBT and no evidence of cuff tear underwent the Gilcreest operation. The mean age of the patients was 32 years (range, 20–49). Six of them were professional gymnasts. The 28 patients that could be traced were evaluated a mean of 31 years after operation. The mean Constant score (CS) was 74 in the entire group, and 86 in 22. The latter patients complained occasionally of mild shoulder pain. The remaining six patients had a mean CS of 56 (range, 40–81). Of the six, four (aged 66–71 years) had clinical and MR evidence of rotator cuff tear. The other two had undergone arthroscopic cuff repair (CS, 75–81). After operation, all professional gymnasts had returned to sport activity and all the other patients had resumed their jobs. After 30 years, the majority of the patients who had undergone the Gilcreest operation had good functional and cosmetic outcomes. Only a few patients had a cuff tear. The role of the LHBT as depressor of the humeral head is probably less important than generally believed.

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References

  1. Rodosky MW, Harner CD, Fu FH (1994) The role of the long head of the biceps muscle and superior glenoid labrum in anterior stability of the shoulder. Am J Sports Med 22:121–130

    Article  PubMed  CAS  Google Scholar 

  2. Pagnani MJ, Deng XH, Warren RF, Torzilli PA, O’Brien SJ (1996) Role of the long head of the biceps brachi in glenohumeral stability: a biomechanical study in cadavera. J Shoulder Elbow Surg 5:255–262

    Article  PubMed  CAS  Google Scholar 

  3. Brown GA, Pena F, Grontvedt T, Labadie D, Engbretsen L (1996) Fixation strength on interference screw fixation in bovine, young human and human cadaver knees: influence of insertion torque, tunnel-bone black gap and interference. Knee Surg Sports Traumatol Arthrosc 3:238–244

    Article  PubMed  CAS  Google Scholar 

  4. Burkhead WZ, Arcand MA, Zeman C (1990) The biceps tendon. In: Rockwood CA, Matsen FA (eds) The shoulder, 3rd edn. Saunders, Philadelphia

    Google Scholar 

  5. Gilcreest EL (1926) Two cases of spontaneous rupture of the long head of the biceps flexor cubiti. Surg Clin North Am 6:539–554

    Google Scholar 

  6. Hitchcock HH, Bechtol CO (1948) Painful shoulder observation on the role of the tendon of the long head of the biceps brachi in its causation. J Bone Joint Surg Am 30:263–273

    Google Scholar 

  7. DePalma AF, Callery GE (1954) Bicipital tenosynovitis. Clin Orthop 3:69–85

    PubMed  CAS  Google Scholar 

  8. Froimson AI, Oh I (1974) Keyhole tenodesis of biceps origin at the shoulder. Clin Orthop 112:245–249

    Google Scholar 

  9. Gartsman GM, Hammerman SM (2000) Arthroscopic biceps tenodesis: operative technique. Arthroscopy 16:550–552. doi:10.1053/jars.2000.4386

    Article  PubMed  CAS  Google Scholar 

  10. Richards DP, Burkhart SS, Lo IKY (2003) Arthroscopic biceps tenodesis with interference screw fixation: The lateral decubitus position. Oper Tech Sports Med 11:15–23

    Article  Google Scholar 

  11. Warren RF (1985) Lesions of the long head of the biceps tendon. Inst Course Lect, vol. 34. Rosemont, IL: American Academy of Orthopaedics Surgeons, pp 204-209

  12. Strunznegger M, Beguin D, Grunig B, Jakob RP (1986) Muscular strength after rupture of the long head of the biceps. Arch Orthop Trauma Surg 105:18–23

    Article  Google Scholar 

  13. Mariani EM, Cofield RH, Askew LJ, Li GP, Chao EY (1988) Rupture of the tendon of the long head of the biceps brachii. Surgical versus non-surgical treatment. Clin Orthop 228:233–239

    PubMed  Google Scholar 

  14. Constant CR, Murley AHG (1987) A clinical method of functional assessment of the shoulder. Clin Orthop 214:160–164

    PubMed  Google Scholar 

  15. Morrey BF, An KN, Chao EYS (1993) Functional evaluation of the elbow. In: The elbow and its disorders. Morrey BF (ed) WB Saunders, Philadelphia, pp 86–89

  16. Petersonn CJ, Redlund-Johnell I (1984) The subacromial space in normal shoulder radiographs. Acta Orthop Scand 55:57–58

    Article  Google Scholar 

  17. Sethi N, Wright R, Yamaguchi K (1999) Disorders of the long head of the biceps tendon. J Shoulder Elbow Surg 8:644–654

    Article  PubMed  CAS  Google Scholar 

  18. Neer CS (1972) Anterior acromioplasty for the chronic impingement syndrome in the shoulder. A preliminary report. J Bone Joint Surg Am 54-A:41–50

    Google Scholar 

  19. Leffert RD, Rowe CR (1989) Tendon rupture. In: Rowe CS (ed) The shoulder. Churchill Livingstone, New York, pp 131–163

    Google Scholar 

  20. Fukuda H, Mikasa M, Ogawa K, Hamada K (1983) The partial thickness tear of the rotator cuff. Orthop Trans 7:137

    Google Scholar 

  21. Ozaki J, Fujimoto S, Nakagawa Y, Masuhara K, Tamai S (1988) Tears of the rotator cuff of the shoulder associated with pathological changes in the acromion. A study in cadavera. J Bone Joint Surg 70-A:1224–1230

    Google Scholar 

  22. Scapinelli R, Candiotto S, Ferrari GP, Iacobellis C (1999) Subcutaneous rupture of the tendon of the long head of the biceps brachii in subacromial impingement syndrome. Chir Organi Mov 84:229–237

    PubMed  CAS  Google Scholar 

  23. Friedel R, Markgraf E, Schmidt I, Dönicke T (1995) Proximal humerus shaft fracture as a complication after keyhole-plasty. A case report. Unfallchirurgie 2:198–201

    Article  Google Scholar 

  24. Friedman DJ, Dunn JC, Higgins LD, Warner JJ (2008) Proximal biceps tendon: injuries and management. Sports Med Arthrosc 16:162–169. doi:10.1097/JSA.0b013e318184f549

    Article  PubMed  Google Scholar 

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Correspondence to Stefano Gumina.

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Gumina, S., Carbone, S., Perugia, D. et al. Rupture of the long head biceps tendon treated with tenodesis to the coracoid process. Results at more than 30 years. International Orthopaedics (SICOT) 35, 713–716 (2011). https://doi.org/10.1007/s00264-010-1099-0

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  • DOI: https://doi.org/10.1007/s00264-010-1099-0

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