Tendinopathy of the long head of the biceps tendon – physical examination confronted with shoulder arthroscopy findings

Jan Zabrzyński, Artur Szumlański

DOI: http://dx.doi.org/10.12775/MBS.2016.008

Abstract


Tendinoapthy is a common medical problem and its aetiopathology is multifactorial. Biceps tendon is more vulnerable to injurie due to anatomic and biomechanical conditions. The aim of the study was to present results of the physical examination and shoulder arthroscopy findings among patients suffering from biceps tendon tendinopathy.

The research was divided into two phases: preoperative and arthroscopic. First phase consisted of clinical examination- five clinical tests, level of pain assessment by use of VAS scale and analysis of the history of disease. Second phase presented  25 patients who underwent shoulder arthroscopy assisted biceps tendon tenotomy or tenodesis.

Clinical examination showed that the most accurate test for biceps tendon tendinopathy was tenderness in the bicipital groove. Mean VAS score was: 7.8. History of subjects tendinopathy was half traumatic and half overuse aetiology. Shoulder arthroscopy revealed other injuries and the most frequent accompanying lesions were rotator cuff tears.

The association between biceps tendon tendinopathy and other shoulder pathologies and problems with accuracy of clinical test have been noted by many authors. Due to  so many accompanying lesions, diagnosis of biceps tendon tendinopathy needs to be supported by other diagnostic methods and shoulder arthroscopy is widely accepted as a gold standard to identify biceps tendon pathology

Keywords


biceps tendinopathy; shoulder arthroscopy; Speed test; Yergason test; biceps tendon

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References


Joseph M, Maresh CM, McCarthy MB,et al. Histological and molecular analysis of biceps tendon, 2009,J Orthop Res. Oct;27(10):1379-85.

Rees JD, Wilson AM, Wolman RL, Current concepts in the management of tendon disorders, 2006, Rheumatology (Oxford).;45(5):508-21.

Ditsios K, Agathangelidis F, Boutsiadis A ,et al. Long Head of the Biceps Pathology Combined with Rotator Cuff Tears, 2012, Adv Orthop. :405-472.

Singaraju VM, Kang RW, Yanke AB, et al. Biceps tendinitis in chronic rotator cuff tears: a histologic perspective. 2008, J Shoulder Elbow Surg.;17(6):898-904.

Riley G. The pathogenesis of tendinopathy. A molecular perspective 2004Rheumatology (Oxford).;43(2):131-42.

Sethi N, Wright R, Yamaguchi K. Disorders of the long head of biceps tendon ,1999, J Shoulder Elbow Surg.; 8(6):644-54.

Gill HS, El Rassi G, Bahk MS,et al. Physical examination for partial tears of biceps tendon. 2007 Am J Sports Med. ;35(8):1334-40.

P. M. Ahrens, P. Boileau, The long head of biceps and associated tendinopathy, 2007 ,J Bone Joint Surg Br.;89(8):1001-9.

Streit JJ, Shishani Y, Rodgers M, et al. Tendinopathy of the long head of the biceps tendon: histopathologic analysis of the extra-articular biceps tendon and tenosynovium. 2015 ,Open Access J Sports Med.;6:63-70Holtby R, Razmjou H. Accuracy of the Speed's and Yergason's tests in detecting biceps pathology and SLAP lesions: comparison with arthroscopic findings. 2004,Arthroscopy.;20(3):231-6.






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