ARTHROSCOPIC TENOTOMY OF THE LONG BICEPS: LONG-TERM OUTCOME

L. Nové-Josserand; A. Boulahia; L. Neyton; G. Walch

doi:10.1302/0301-620X.87BSUPP_II.0870140a

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ARTHROSCOPIC TENOTOMY OF THE LONG BICEPS: LONG-TERM OUTCOME

L. Nové-Josserand
A. Boulahia
L. Neyton
G. Walch

ARTHROSCOPIC TENOTOMY OF THE LONG BICEPS: LONG-TERM OUTCOME

Nové-Josserand L, Boulahia A, Neyton L, Walch G. ARTHROSCOPIC TENOTOMY OF THE LONG BICEPS: LONG-TERM OUTCOME. Orthop Procs. 2005;87-B(SUPP_II):140-140. doi:10.1302/0301-620X.87BSUPP_II.0870140a

Nové-Josserand, L., et al. “ARTHROSCOPIC TENOTOMY OF THE LONG BICEPS: LONG-TERM OUTCOME.” Orthopaedic Proceedings, vol. 87-B, no. SUPP_II, 2005, pp. 140-140., https://doi.org/10.1302/0301-620X.87BSUPP_II.0870140a

Nové-Josserand, L., Boulahia, A., Neyton, L., & Walch, G. (2005). ARTHROSCOPIC TENOTOMY OF THE LONG BICEPS: LONG-TERM OUTCOME. Orthopaedic Proceedings, 87-B(SUPP_II), 140-140. https://doi.org/10.1302/0301-620X.87BSUPP_II.0870140a

Nové-Josserand, L., Boulahia, A., Neyton, L. and Walch, G. (2005) “ARTHROSCOPIC TENOTOMY OF THE LONG BICEPS: LONG-TERM OUTCOME.” Orthopaedic Proceedings, 87-B(SUPP_II), pp. 140-140. Available at: https://doi.org/10.1302/0301-620X.87BSUPP_II.0870140a

Nové-Josserand, L., A. Boulahia, L. Neyton, and G. Walch. “ARTHROSCOPIC TENOTOMY OF THE LONG BICEPS: LONG-TERM OUTCOME.” Orthopaedic Proceedings 87-B, no. SUPP_II (2005): 140-140. https://doi.org/10.1302/0301-620X.87BSUPP_II.0870140a

Nové-Josserand L, Boulahia A, Neyton L, Walch G. ARTHROSCOPIC TENOTOMY OF THE LONG BICEPS: LONG-TERM OUTCOME. Orthop Procs. 2005 Apr 1;87-B(SUPP_II):140-140. https://doi.org/10.1302/0301-620X.87BSUPP_II.0870140a

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Abstract

Purpose: Appropriate treatment of full-thickness tears of the rotator cuff with subacromial impingement remains a subject of debate. Considering that in most patients, spontaneous tears of the long biceps tendon reduces the pain and that subacromial osteoarthritis is well tolerated by many patients, we proposed arthroscopic tenotomy of the long biceps in this indication with the aim of relieving pain. We report here the long-term outcome.

Material and methods: Between 1988 and 1999, 307 arthroscopic tenotomies of the long biceps tendon were performed in patients with unrepairable tears of the rotator cuff tendons (massive full thickness tears, old patients, non-motivated patients). The procedure was isolated in 64% and associated with acromioplasty in 36%. All patients were given prior medical treatment. Mean age at surgery was 64.3 years. The preoperative subacromial height was 6.6 mm. The tendon lesion was an isolated tear of the supraspinatus in 31%, tears of two tendons in 44.6% and tears of three tendons in 21.8%, and isolated tears of the subscapularis in 2.6%. Mean follow-up was 57 months (24–168).

Results: The Constant score improved from 48.4 to 67.6 points (p< 0.001). Glenohumeral osteoarthritis (Samilson) increased from 38% to 67% of the shoulders postoperatively. Association with acromioplasty improved the objective and subjective result solely in the group of isolated tears of the supraspinatus. The size of the tear and the degree of fatty degeneration of the rotator cuff muscles had a statistically significant influence on functional and radiographic outcome (p< 0.001) while time since surgery had no effect on radiographic outcome (p< 0.001).

Discussion: This simple easy-to-perform procedure yielded pain relief at rest and also nighttime pain. It can be recommended for massive rotator cuff tears with sub-acromial impingement in elderly or poorly-motivated patients whose pain fails to respond to medical treatment. This procedure does not allow recovery of shoulder motion or force.

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