The incidence of pathologic changes of the long head of the biceps tendon.

The incidence of primary and secondary bicipital tendinitis remains unknown. In our prospective study, 200 consecutive shoulders underwent arthroscopic subacromial decompression for impingement syndrome. A biceps tenodesis was performed in 80 shoulders (40%) featuring macroscopic degeneration of the long head of the biceps; rotator cuff tears were apparent in 91% of these shoulders, the mean patient age being 55 years.

Recurrent instability of the shoulder after age 40.

Twelve patients who had recurrent instability of the shoulder with onset after age 40 were reviewed. Eleven had anterior instability, and one had a posterior dislocation. The average age of the patients was 62.

Incomplete rotator cuff tears. A technique for diagnosis and treatment.

The size and location of intratendinous and joint side rotator cuff tears can be diagnosed by a technique known as positional arthrography. The site and extent of the tears diagnosed preoperatively by this technique correlated well with intraoperative findings in a study group of 200 patients who underwent a combined arthroscopic and open procedure to localize, identify, and repair incomplete rotator cuff tears.

Anterior dislocation of the shoulder and rotator cuff rupture.

Thirty-seven patients older than 40 years of age were seen after sustaining primary anterior dislocations of the shoulder. An associated rupture of the rotator cuff in each patient had been missed, often being mistaken for an axillary neuropathy. Eleven of these patients developed recurrent anterior instability that was due to rupture of the subscapularis and anterior capsule from the lesser tuberosity.

The GLAD lesion: another cause of anterior shoulder pain.

A GLAD (glenolabral articular disruption) lesion is caused by a forced adduction injury to the shoulder from an abducted and external rotated position; patients with GLAD lesions present with anterior shoulder pain as their chief complaint. No signs of anterior instability are found on physical examination or at surgery. All cases are relieved of anterior shoulder pain by lidocaine injection intraarticularly during the arthrographic examination, but arthrographic examinations are normal.