Long Head of the Biceps Tendon Lesion Associated with Rotator Cuff Tear

Kim,  Young Kyu; Kim,  Dong Wook; Lee,  Jong Hun

doi:2010.13.1.64

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Original Article

Journal of the Korean Shoulder and Elbow Society 2010;13(1):64-71.
DOI: https://doi.org/10.5397/CiSE.2010.13.1.064 Published online June 30, 2010.

Long Head of the Biceps Tendon Lesion Associated with Rotator Cuff Tear

Young Kyu Kim, Dong Wook Kim, Jong Hun Lee

¹Department of Orthopaedic Surgery, Gil Medical Center, Gachon University, Inchon, Korea.
²Department of Orthopaedic Surgery, University of Sungkyunkwan School of Medicine, Masan Samsung Hospital, Korea. okspirit2@naver.com

회전근 개 파열과 동반된 상완 이두 건 장두의 병변

김영규·김동욱*·이종훈

가천의과학대학교 길병원 정형외과학교실, 성균관대학교 마산삼성병원 정형외과학교실

Abstract

PURPOSE
To evaluate pathologic patterns and outcomes of treatment of a biceps tendon lesion associated with a rotator cuff tear. MATERIALS AND METHODS: We reviewed 92 patients (i) who underwent surgery for a cuff tear, (ii) for whom the biceps lesion could be observed retrospectively, and (iii) had a minimum follow-up of 2 years. The pathology of biceps tendon was classified into 4 types: tenosynovitis, fraying or hypertrophy, tear, and instability. All but the 4 with massive cuff tears were repaired. The biceps lesions were treated with debridement in 30, tenotomy in 10, tenodesis in 8, and recentering in 4. UCLA scoring was used for clinical results.
RESULTS
Seventy patients had a biceps lesion, 19 tenosynovitis, 22 fraying or hypertrophy, 21 a tear, and 8 instability. A biceps lesion was observed in 63% of cases of cuff tears below the medium size, and in 88% of cases with cuff tears above the large size. UCLA scores according to the pathology of the biceps lesion were 29.6 in the absence of a biceps lesion, and 28.3 in its presence. UCLA scores in patients with tenotomy or tenodesis for associated biceps tendon lesions were 28.2.
CONCLUSION
There is a greater incidence and severity of a biceps lesion with a larger cuff tear. Therefore, the cause of a biceps lesion might be related to the cause of the cuff tear. Among the several options of treatment for biceps lesion, tenotomy or tenodesis may be particularly effective in providing pain relief.

Key Words: Rotator cuff; Biceps tendon; Rotator cuff repair; Tenotomy; Tenodesis

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