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L-Shape Superior Capsular Augmentation Technique Using Biceps Tendon: The Biceps L-Shape Shifting Technique.

ABSTRACT: Many therapies have been developed for patients with mass rotator cuff tears. Partial repair is often performed in patients with partially repairable massive rotator cuff tears because it is simpler to perform than superior capsule reconstruction. It may, however, result in rotator cuff retears frequently. This article presents our modified technique of arthroscopic partial reconstruction of the superior capsule using the long head of the biceps tendon with a biceps interposition.

SUBMITTER: Kim DS

PROVIDER: S-EPMC7301214 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:PurposeThe purpose of this study was to investigate the elongation of the biceps muscle tendon unit after rerouting of the long head of the biceps tendon without transection, with and without release of the transverse humeral ligament in a 3-dimensional model.MethodsA total of 60 sets of computed tomography images of shoulders were acquired, and a point-cloud model was generated after 3-dimensional reconstruction. Simulation of rerouting of the long head of the biceps tendon was performed by assuming that the long head of the biceps tendon travels to the center of the greater tuberosity from the supraglenoid tubercle and then back to the bicipital groove distally, with or without the release of the transverse humeral ligament. The elongation of the biceps muscle tendon unit by both manners was measured and correlated with age, height, weight, body mass index, gender, and hand dominance.ResultsThe mean length of the long head of the biceps tendon is 74.22 ± 3.06 mm, and the length is significantly longer, at 112.23 ± 4.92 mm (P = 0.0002) and 96.47 ± 2.58 mm (P = 0.0004). The absolute elongation of the biceps muscle tendon unit after rerouting of the long head of the biceps tendon, without or with transverse humeral ligament release, showed significant differences, which were 38.73 ± 3.03 mm and 22.28 ± 3.25 mm, respectively (P = 0.0008). No significant correlations were observed between the amount of the elongation and the subject's age, height, weight, or body mass index. No significant difference was observed in the amount of the elongation between differing gender and hand dominance.ConclusionsRerouting of the long head of the biceps tendon resulted in significant elongation of the biceps muscle tendon unit. Release of the transverse humeral ligament partially decreased this elongation.Clinical relevanceRerouting of the long head of the biceps tendon may lead to overtension of the biceps. If it is adopted in clinical use, transverse humeral ligament release is recommended.

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L-Shape Superior Capsular Augmentation Technique Using Biceps Tendon: The Biceps L-Shape Shifting Technique.

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