Background: For irreparable rotator cuff tears, 3-layer tendon reconstruction (in which in-situ superior capsular reconstruction-reinforced partial rotator cuff repair was augmented with hamstring-sheet-lengthened middle trapezius tendon transfer) was recently reported to achieve satisfactory postoperative outcomes. To avoid hamstring graft-related drawbacks, the current note describes a technical modification of that reconstruct; wherein long head of biceps tendon is used as a cornerstone structure for simultaneously reconstructing the superior capsule; lengthening the transferred middle trapezius tendon; and augmenting the partially-repaired rotator cuff.
Methods: Via sub-pectoral approach, long head of biceps tendon is distally-tenotomized. Through McKenzie approach, proximal stump of the tenotomized long head of biceps is retrieved to the sub-acromial space where double-row biceps tenodesis (into a trough at the greater tuberosity) is performed for reconstructing the superior capsule. Next, postero-superior rotator cuff is partially repaired, and side-to-side sutured to the reconstructed capsule. Through a 7-8-cm skin incision over the medial scapular spine, middle trapezius tendon is released. Portion of long head of biceps tendon distal to the tenodesis site is retrieved via a sub-trapezius/sub-acromial corridor to the scapular wound where it is re-attached to the released middle trapezius tendon.
Results: Use of long head of biceps tendon as a common local graft (for simultaneously reconstructing the superior capsule, lengthening the transferred middle trapezius tendon, and augmenting the partially-repaired rotator cuff) is technically feasible provided that the harvested tendon stump is at least 10 cm in length.
Conclusion: While avoiding hamstring graft-related complications, the currently-reported biceps-based 3-layer rotator cuff tendon reconstruction might offer the advantages of reproducibility, safety, simplicity and quickness; however, it should be validated via further studies. Trial registration The present study was approved by the Institutional Committee of Scientific Research and Ethics (3-2023Orth10-1).
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http://dx.doi.org/10.1186/s13018-023-03978-0 | DOI Listing |
J Shoulder Elbow Surg
January 2025
Background: Shoulder arthroplasty is increasingly performed for shoulder conditions such as arthritis, rotator cuff arthropathy, and traumatic injuries. Registries and other compilations of patient data provide the opportunity to detect meaningful differences in outcomes between alternative techniques and implants. A wide range of outcome measurements are reported after shoulder arthroplasty, but the sample sizes needed to identify meaningful differences has not been studied systematically.
View Article and Find Full Text PDFPhys Ther
January 2025
IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.
Importance: Rotator cuff tendinopathy represents the most prevalent cause of shoulder pain, the third most common musculoskeletal disorder after low back pain and knee pain.
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Design: This study was a systematic review and meta-analysis of randomized controlled trials.
Am J Sports Med
January 2025
Department of Orthopaedic Surgery and Rehabilitation, University of Texas Medical Branch, Galveston, Texas, USA.
Background: Views surrounding acromioplasty at the time of arthroscopic rotator cuff repair (RCR) have shifted dramatically over time. In recent years, various studies have argued against acromioplasty, citing equivocal functional outcomes after arthroscopic RCR with or without acromioplasty.
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J Orthop Surg Res
January 2025
Department of Orthopaedic Surgery, Yeosu Baek Hospital, 50, Yeosu 1-ro, Yeosusi, Yeosu-si, Jeollanam-do, Republic of Korea.
Background: There are various options of tendon transfer according to the different types of irreparable rotator cuff tears (IRCTs). However, there were no clear treatment options for the IRCTs involving the anterior, superior and posterior rotator cuff tears (global IRCTs). Latissimus dorsi and teres major (LDTM) could be transferred anteriorly or posteriorly in global IRCTs.
View Article and Find Full Text PDFJ Ultrasound
January 2025
Department of Physical Medicine and Rehabilitation, University of Health Science Fatih Sultan Mehmet Training and Research Hospital, E5 Karayolu Üzeri, İçerenköy-Ataşehir, 34752, Istanbul, Turkey.
Shoulder Injury Related to Vaccine Administration (SIRVA) is a complication caused by improperly administered vaccinations. It triggers an inflammatory cascade that damages shoulder structures, resulting in prolonged shoulder pain and restricted range of motion. Common diagnoses in SIRVA patients include shoulder bursitis (all classified as subacromial bursitis), adhesive capsulitis, and rotator cuff injuries such as tears or tendinopathy.
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