Surgical Treatment of Patients with Damage to the Ligaments Holding the Long Head of the Biceps (Pulley Lesion) in Combination with Contracture of the Shoulder Joint
ARTICLE PDF (Українська)

Keywords

shoulder joint
contracture
tendon of the long head of the biceps
secondary adhesive capsulitis

How to Cite

Bohdan, S., Yuriichuk, L., & Lieskov, V. (2023). Surgical Treatment of Patients with Damage to the Ligaments Holding the Long Head of the Biceps (Pulley Lesion) in Combination with Contracture of the Shoulder Joint . TERRA ORTHOPAEDICA, (3(118), 16-21. https://doi.org/10.37647/2786-7595-2023-118-3-16-21

Abstract

Background. Damage to the ligaments holding the long head of the biceps, or Pulley Lesion injuries, are often accompanied by contracture of the shoulder joint.

Objective. The objective of the study was to compare the treatment outcomes of patients with Pulley Lesion injuries and secondary adhesive capsulitis.

Material and Methods. The study included 82 patients with contracture of the shoulder joint and damage to the ligaments holding the long head of the biceps. The patients were divided into 2 groups depending on the extent of surgical intervention: group 1 underwent subpectoral tenodesis and selective capsulotomy of the shoulder joint; group 2 underwent subpectoral tenodesis without selective capsulotomy of the shoulder joint. The function of the shoulder joint was assessed using the Constant Shoulder Score and VAS scales before surgery, at 3 and 6 months after the surgery.

Results. At 3 months follow-up, the average functional result according to the Constant Shoulder Score was somewhat worse in group 2 (14.5±5.2 points) than in group 1 (8.5±6.4 points), p = 0.031. At 6 months follow-up, the average functional result according to the Constant Shoulder Score was 5.1±5.6 points in group 1 and 10.1±4.1 points in group 2 (p = 0.024). At 3 months follow-up, the average VAS score was worse in group 2 than in group 1 and reached 2.81±0.7 points. At 6 months follow-up, the average VAS score in group 2 was also worse than in group 1 (p = 0.051).

Conclusions. Performing selective capsulotomy and subpectoral tenodesis in patients with secondary adhesive capsulitis and damage to the ligaments holding the long head of the biceps (Pulley Lesion injuries) allows us to achieve better functional results both according to the Constant Shoulder Score and the VAS scale at 3 and 6 months after the surgery.

https://doi.org/10.37647/2786-7595-2023-118-3-16-21
ARTICLE PDF (Українська)

References

Matsen FA, Cordasco FA, Sperling JW, Lippit SB. Rockwood and Matsen's The shoulder. 6th Edition. Elsevier; 2022. 1108 p.

Kelly JD. Elite techniques in shoulder arthroscopy. Philadelphia: Springer; 2016. 334 р. DOI: 10.1007/978-3-319-25103-5

McMahon PJ. Rotator cuff injuries a clinical casebook. Pittsburgh: Springer; 2017. 363 р. DOI: 10.1007/978-3-319-63668-9.

Lancaster ST, Grove TN, Woods DA. Management of post-traumatic stiffness of the shoulder following upper limb trauma with manipulation under anaesthetic. Shoulder Elbow. 2017;9:258-265. doi: 10.1177/1758573217693974

Itoi E, Arce G, Bain GI, et al. Shoulder stiffness: current concepts and concerns. Arthroscopy. 2016;32:1402-1414. doi: 10.1016/j.arthro.2016.03.024

McNamara WJ, Lam PH, Murrell GA. The relationship between shoulder stiffness and rotator cuff healing: a study of 1,533 consecutive arthroscopic rotator cuff repairs. J Bone Joint Surg Am. 2016;98:1879-1889. doi: 10.2106/JBJS.15.00923

Ando A, Sugaya H, Hagiwara Y, et al. Identification of prognostic factors for the nonoperative treatment of stiff shoulder. Int Orthop. 2013;37:859-864. doi: 10.1007/s00264-013-1859-8.

Braun S., Imhoff A.B. Modern treatment strategies for the long head of the biceps tendon. Orthopade. 2018 Feb;47(2):113-120. doi: 10.1007/s00132-017-3514-3.

Diplock B., Hing W., Marks D. The long head of biceps at the shoulder: a scoping review. BMC Musculoskelet Disord. 2023 Mar 28;24(1):232. doi: 10.1186/s12891-023-06346-5.

Kim J., Nam J. H., Kim Y., et al. Long Head of the Biceps Tendon Tenotomy versus Subpectoral Tenodesis in Rotator Cuff Repair. Clin Orthop Surg. 2020 Sep;12(3):371-378. doi: 10.4055/cios19168.

Fang J., Dai X., Yu X., et al. Lesions of the Long Head of the Biceps Tendon Concomitant with Rotator Cuff Tears: Tenotomy or Subpectoral Mini-open Tenodesis? A Comparative Short to Mid-term Follow-up Study. Orthop Surg. 2019 Oct;11(5):857-863. doi: 10.1111/os.12536.

J.Ramirez Adhesive capsulitis: Diagnosis and Management Am Fam Physician. 2019; 99(5):297-300.

Fields BKK, Skalski MR, Patel DB, et al. Adhesive capsulitis: review of imaging findings, pathophysiology, clinical presentation, and treatment options. Skeletal Radiol. 2019;48(8):1171-1184. doi: 10.1007/s00256-018-3139-6.

Ebrahimzadeh MH, Moradi A, Bidgoli HF, Zarei B. The relationship between depression or anxiety symptoms and objective and subjective symptoms of patients with frozen shoulder. Int J Prev Med. 2019;10:38. doi: 10.4103/ijpvm.IJPVM_212_17.

Zhang C., Yang G, Li Т. Biceps Tenodesis Better Improves the Shoulder Function Compared with Tenotomy for Long Head of the Biceps Tendon Lesions: A Meta-Analysis of Randomised Controlled Trials. J Clin Med. 2023 Feb 22;12(5):1754. doi: 10.3390/jcm12051754.

Lee H.J., Kim E.S., Kim Y.S. What happens to the long head of the biceps tendon after arthroscopic rotator cuff repair? Bone Joint J. 2020;102-B:1194–1199. doi: 10.1302/0301-620X.102B9.BJJ-2020-0076.R1.

Zhu X.M., Leroux T., Ben-David E., Dennis B., Gohal C., Kirsch J.M., Khan M. (et all). A meta-analysis of level I evidence comparing tenotomy vs tenodesis in the management of long head of biceps pathology. J. Shoulder Elbow Surg. 2021;30:961–968. doi: 10.1016/j.jse.2021.02.002.

Belk J.W., Kraeutler M.J., Houck D.A., Chrisman A.N., Scillia A.J., McCarty E.C. Biceps tenodesis versus tenotomy: A systematic review and meta-analysis of level I randomized controlled trials. J. Shoulder Elbow Surg. 2021;30:951–960. doi: 10.1016/j.jse.2020.11.012.

Pozzetti Daou J., Nagaya D.Y., Matsunaga F.T., Sugawara Tamaoki M.J. Does Biceps Tenotomy or Tenodesis Have Better Results After Surgery? A Systematic Review and Meta-analysis. Clin. Orthop. Relat. Res. 2021;479:1561–1573. doi: 10.1097/CORR.0000000000001672.

Ahn J., J Kim J., S. Shin S. Arthroscopic suprapectoral biceps tenodesis provided earlier shoulder function restoration compared with open subpectoral biceps tenodesis during the recovery phase. J Shoulder Elbow Surg. 2023 Aug 11:S1058-2746(23)005797. doi:10.1016/j.jse.2023.07.008.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.