2017 ISAKOS Biennial Congress ePoster #2202
Evaluation of Distal Pullout Strength of the Biceps Long Head Tendon According to Pathologies in Rotator Cuff Repair
Sae Hoon Kim, MD, PhD, Seoul KOREA, REPUBLIC OF
Young Jun Kim, MD, Seoul, Korea, seoul KOREA, REPUBLIC OF
Hwa-Ryeong Lee, DPT, Seoul KOREA, REPUBLIC OF
Young Eun Choi, BS, Seoul KOREA, REPUBLIC OF
Seoul National University Hospital , Seoul, KOREA, REPUBLIC OF
FDA Status Not Applicable
Summary
In this study, we analyzed distal pullout tension of LHBT according to its pathologies. To our knowledge, this is the first study analyzed pullout strength of LHBT according to pathologies of LHBT and adjacent tissues in real clinical situation. We hypothesized that the pullout tension of LHBT would be different according to the pathologies of the surrounding tissues and LHBT
ePosters will be available shortly before Congress
Abstract
Background
Pathologies of the long head of the biceps tendon (LHBT) is frequently recognized in rotator cuff tear. Recommendations for managing LHBT pathologies are still in debate. Distal migration of the tenotomized biceps is always concern when only tenotomy is performed.
Purpose
During subpectoral tenodesis of LHBT, pullout tension was measured with digitalized tensiometer. The tension was analyzed according to pathologies of the adjacent tissue in proximity of LHBT as well as pathologies of LHBT.
Hypothesis
The pullout tension of LHBT would be different according to the pathologies of the surrounding tissues and LHBT.
Study Design: Case series; Level of evidence, 4.
Materials And Methods
70 patients with a mean age of 60.4 ± 6.9 years (range: 44 to 82 years) were studied. The patients had undergone arthroscopic rotator cuff repair and subpectoral tenodesis. During subpectoral tenodesis, the tensiometer was set to measure peak tension and manual traction was applied to the tensiometer until LHBP was pulled out from the bicipital groove. Each data of patients was recorded according to sex, biceps tear itself, subscapulars (SSC) tear, SLAP lesion, biceps location, pulley lesion.
Results
The mean pullout tension of LHBT showed 86.5 ± 42.1 N (26.7-240.5 N). Distal pullout tension of LHBT was statistically higher in male compare to that of female (m: 93.2 ± 42.7 vs f: 73.7 ± 38.7, P = 0.041). However, the pullout tension of LHBT was not significantly different for pathologies of the surrounding tissues and LHBT
Conclusion
The result of the study fail to show pullout tension difference in associated pathologies may affect distal migration of tenotomized LHBT. Gender is only factor affects pullout strength of LHBT. There is no good way to predict occurrence of Popeye deformity based on observed pathologies by arthroscope. Tenotomy of LHBT, when it is indicated, may be good option for majority of rotator cuff tear patients.
Key Words: long head of the biceps tendon, distal migration, Popeye deformity, pullout strength, vinculum