Aim: The diagnosis of partial biceps tears cannot be made reliably with existing physical exam tests. Diagnostic arthroscopy is recommended if this diagnosis is suspected.

The accuracy of the physical examination for biceps pathology remains controversial. The goal of this study was to investigate the validity and clinical usefulness of various physical tests used for diagnosing partial tears of the biceps tendon.

Materials & Methods: The study was a prospective blinded study of 847 consecutive patients who underwent arthroscopic procedures for a variety of shoulder conditions. Forty subjects were found at the time of arthroscopy to have partial biceps tears (24 men and 16 women) with an average age of 59 YO (range from 18 to 83 YO). A pre-operative physical examination using 9 different commonly used tests was performed for all the patients. Statistical analysis included sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) and likelihood ratios (LR) for these tests.

Results: The prevalence rate of partial tears was 5 percent of all arthroscopic procedures. Associated conditions included rotator cuff tears (85 percent) and anterior instability (7.5 percent). The sensitivity, specificity, PPV, NPV and the LR for the Speed_s test were 50 percent, 67 percent, 8 percent and 96 percent and 1.51, respectively. None of the other tests was sensitive (less than 50 percent). The lift-off sign had a LR of 2.61 but had a sensitivity of only 28 percent.

Conclusion: The diagnosis of partial biceps tears cannot be made reliably with existing physical exam tests. Diagnostic arthroscopy is recommended if this diagnosis is suspected.

Aim: Distal clavicle excision (DCE) is the treatment of choice for A–C joint arthritis.The overall complication rate for open, isolated DCE is higher than previously reported.

Distal clavicle excision (DCE) is the treatment of choice for A–C joint arthritis. Isolated DCE., as an open procedure has been considered to be a safe procedure, and it is the gold standard for comparison for arthroscopic distal clavicle excision. This study attempts to define the incidence of complications after isolated, open DCE.

Materials & Methods: This prospective, non-randomized study included 702 patients who underwent arthroscopic surgery of the shoulder. 580 patients were included in the control group. All patients underwent a thorough preoperative evaluation and final diagnosis was given after arthroscopic evaluation. There were 42 patients with isolated A–C joint arthritis, which underwent an open D.C.E. Mean follow up was 16.7 months. There were 30 men and 12 women with a mean age of 42,6 (± 12,5) years. The dominant arm was involved in 30 patients. 16 patients participated in sports while 9 of them were competitive athletes. 38 (90%) patients had symptomatic arthritis, 2(5%) cases were of osteolysis and separation arthritis each.

Results: 22 (52%) of the 42 patients developed complications. There were 2 deep infections and 2 stitches abscesses. 4 (9.5%) patients developed a stiff shoulder and 1(2.4%) patient developed heterotopic ossification. 16 (38%) patients had tenderness in A–C joint for a period over 3 months while 6 (14%) patients had local tenderness at the last follow up. Painful scar was present in 2 (5%) patients over 3 months.

Conclusions: The overall complication rate for open, isolated DCE is higher than previously reported. Patients should be advised of these possibilities and this study serves as a baseline for comparison for future study.