als PDF - AGA

Schulter
AGA2012-179
Arthroscopic Identification of Proximal Biceps Tendon Pathology: Do we miss and
underestimate pathology?
Arthroscopic Identification of Proximal Biceps Tendon Pathology: Do we miss and
underestimate pathology?
Authors
* Dan Guttmann TOI Taos Orthopaedic Institute, Taos, United States
* Ariana Demers Sierra Orthopedic Institute, Sonora, United States
James Lubowitz TOI Taos Orthopaedic Institute, Taos, United States
Abstract
Fragstellung: Summary
Arthroscopic evaluation of the intraarticular LHB tendon can only evaluate 32% of the total length of the tendon,
misses distal pathology in 50% of cases and therefore may underestimate pathology present.
Introduction
The purpose of this study is to compare the arthroscopic versus gross appearance of the proximal biceps in
patients undergoing open subpectoral biceps tenodesis. Our hypothesis is that pathology of the long head of the
biceps (LHB) may not be fully revealed arthroscopically, and biceps tendon pathology is underestimated
arthroscopically, in comparison with gross inspection.
Methodik: Methods
Patients undergoing shoulder arthroscopy with subpectoral biceps tenodesis had arthroscopic inspection of the
biceps tendon with pathology assessment. The initial distal extent of biceps visualization was marked; the tendon
was then pulled into the joint, and marked. During open subpectoral tenodesis, measurements were made of
these marks and the whole length of the tendon was also measured. The gross pathology of the tendon was
evaluated and then the excised tendon specimen underwent histology assessment.
Ergebnis: Results
The total average length of the biceps tendon was 96.2 mm (75-130mm). Arthroscopic observation of the biceps
tendon was 16.5mm (17%) (range 5-28mm). Pulling the tendon into the joint, the average length seen was
32.3mm (32%) (range15-45mm). A paired t-test compared the two groups. There were significant differences (p =
.001). Pathology that was observed on open inspection, but missed arthroscopically was 31/62 (50%) of
specimens. Pathology was underestimated in 35/62 (56%) patients.
Schlussfolgerung: Discussion/Conclusion
Our results demonstrate long head of the biceps tendon (LHBT) pathology is missed arthroscopically 50% of the
time, and biceps tendon pathology is underestimated arthroscopically, in comparison with gross inspection.
Keywords
Arthroscopy, biceps, tendon, tenodesis
16.03.2012 145
Vortrag
(c) by CVS://Abstractmanagement