Dataset Information

Endoscopic transtendinous repair for partial-thickness proximal hamstring tendon tears.

ABSTRACT: Partial tears of the proximal hamstring tendon can successfully be managed with tendon repair in cases of failed conservative management. As in partial-thickness gluteus medius repair, a transtendinous technique can be used to repair partial-thickness undersurface tears of the hamstring origin. This report details an endoscopic transtendinous approach for the treatment of partial-thickness hamstring tendon tears.

SUBMITTER: Jackson TJ

PROVIDER: S-EPMC3986502 | biostudies-literature | 2014 Feb

REPOSITORIES: biostudies-literature

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Endoscopic transtendinous repair for partial-thickness proximal hamstring tendon tears.

Jackson Timothy J TJ Trenga Anthony A Lindner Dror D El-Bitar Youseff Y Domb Benjamin G BG

Arthroscopy techniques 20140131 1

Partial tears of the proximal hamstring tendon can successfully be managed with tendon repair in cases of failed conservative management. As in partial-thickness gluteus medius repair, a transtendinous technique can be used to repair partial-thickness undersurface tears of the hamstring origin. This report details an endoscopic transtendinous approach for the treatment of partial-thickness hamstring tendon tears. ...[more]

PMID: 24749032

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Project description:BackgroundPatients with partial thickness rotator cuff tears (PTRCTs) often present with concurrent pathology of the long head of the biceps tendon (LHBT). To address both conditions simultaneously, long head of the biceps (LHB) tenotomy or tenodesis can be performed at the time of arthroscopic rotator cuff repair (RCR). This study aims to compare postoperative shoulder active range of motion (AROM) and complications following transtendinous RCR with concurrent LHB tenodesis or tenotomy.MethodsA total of 90 patients with PTRCTs met inclusion criteria for this study. Patients who underwent tear-completion-and-repair, revision surgery, or open repair of the LHB tendon were excluded. Patients were stratified into tenotomy, arthroscopic suprapectoral tenodesis, or no biceps operation cohorts and were propensity matched 1:1:1 on age, sex, body mass index, and smoking status. Primary outcome measures included AROM in forward flexion, abduction, external rotation, and internal rotation at 6 weeks, 3 months, and 6 months postoperatively. The development of severe stiffness and rates of rotator cuff retear at final follow-up were recorded as secondary outcomes.ResultsWhen comparing the tenotomy and tenodesis cohorts, tenotomy patients were found to have increased AROM at 3 months in forward flexion (153.2° vs. 130.1°, P = .004), abduction (138.6° vs. 114.2°, P = .019), and external rotation (60.4° vs. 43.8°, P = .014), with differences in forward flexion remaining significant at 6 months (162.4° vs. 149.4°, P = .009). There were no significant differences in interval rates of recovery in any plane between cohorts. Additionally, there were no significant differences in rates of symptomatic retears between groups (P = .458). Rates of severe postoperative stiffness approached but did not achieve statistical significance between tenotomy (4.2%) and tenodesis (29.2%) cohorts (P = .066). Smoking status was a significant predictor of severe stiffness (odds ratio, 13.69; P = .010).ConclusionDespite significant differences in absolute AROM between cohorts, the decision to perform tenotomy or tenodesis was not found to differentially affect rates of AROM recovery for patients undergoing arthroscopic transtendinous RCR for PTRCT. Notably, however, transient stiffness complications were more commonly observed in smokers, and data trends suggested an increased risk of stiffness for patients undergoing LHB tenodesis. Overall, postoperative stiffness is likely multifactorial and attributable to both patient- and procedure-specific factors, and LHB tenotomy may be more appropriate for patients with risk factors for developing stiffness postoperatively.

Dataset Information

Endoscopic transtendinous repair for partial-thickness proximal hamstring tendon tears.

Publications

Endoscopic transtendinous repair for partial-thickness proximal hamstring tendon tears.

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