Arthroscopic biceps tenodesis: Indications and technique

Biceps tendon pathology commonly occurs in combination with other shoulder disorders, such as subacromial impingement and rotator cuff tears. Although the arthroscopic treatment of impingement and rotator cuff tears has previously been reported, arthroscopic biceps tenodesis has rarely been described. In this article, we present our technique of arthroscopic biceps tenodesis, which uses a uniquely designed Bio-Tenodesis screw system. This system allows intra-articular manipulation of the biceps tendon, ensures placement of the tendon into the base of the bone socket, allows insertion of the screw while maintaining the position and tension in the tendon, and ensures an adequate screw-tendon-bone interface.     

Modified Two-Incision Approach for Repair of Distal Biceps Tendon Rupture

Rupture of the distal biceps tendon is an uncommon injury that usually results from an excessive eccentric load across the biceps tendon. Various operative techniques have been described but anatomical repair is preferred to restore near native function in patients for whom such deficits would be debilitating. Boyd and Anderson originally described a 2-incision technique that minimizes the incidence of surgical complications while restoring anatomical function. This technique was further modified by Morrey to reduce the rate of ectopic bone formation that has been observed in the original Boyd-Anderson approach. With Morrey’s modification, the 2-incision approach is a safe and effective method for repair of a distal biceps tendon rupture. We describe the modified procedure in full and report on recovery, complications, and comparative outcomes.     

Arthroscopic biceps tenodesis with interference screw fixation: The lateral decubitus position

The tendon of the long head of biceps brachii is an important stabilizer within the glenohumeral joint. Bicepstendon pathology commonly occurs in the presence of concomitant shoulder disorders, such as subacromial impingement, and rotator cuff tears. Biceps tenodesis is indicated in the case of a partial tear (50%), an unstable biceps tendon due to an incompetent medial sling, and in the presence of a torn subscapularis. This article will describe our technique of arthroscopic biceps tenodesis with biodegradable interference screw fixation. This technique uses a uniquely designed Bio-Tenodesis screw system (Arthrex Inc., Naples, FL) and is performed with the patient in the lateral decubitus position.     

Rupture of the Short Head of the Biceps and Coracoid Fractures: Mechanism and Refixation

Injuries of the short head of the biceps are rarely seen in clinics as seen by a lack of published articles. Most of the literature report on coracoid fractures, whereas these scapula process fractures remain less common in the upper extremity. They are caused by direct impact or are associated with acromioclavicular or anterior shoulder dislocation as it may occur in sports. The attached biceps short head, coracobrachialis and pectoral minor tendon are likely to tension an avulsion and displace a fragment. The most favorable treatment is a non-operative therapy, especially if the displacement of fragments is little and the coracoclavicular ligaments maintain the fragments in position. Widely displaced fractures cause a high nonunion rate and surgical reposition and fixation is recommended in such cases. Different fixation techniques are present due to its rare and heterogenic occurrence. However, surgically treated fractures are likely to heal and patients gain full range of motion after three months. We present a case report from our department and demonstrate different operative techniques in a cadaver model.     

关节镜下经髌内侧入路空心钉固定治疗前交叉韧带胫骨止点撕脱骨折

目的:探讨关节镜下经髌内侧入路空心钉固定治疗前交叉韧带胫骨止点撕脱骨折的临床疗效。方法:回顾性分析2008年10月至2011年9月的32例前交叉韧带胫骨止点撕脱骨折患者的病例资料,全部患者采用关节镜下经髌内侧入路导入空心钉进行骨折内固定,采用膝关节功能评分及影像学检查评估术后疗效。结果:术后膝关节侧位片螺钉与胫骨平台夹角平均为(48°±7.3°),随访8~32个月,平均18个月,骨折愈合平均时间为(6.5±0.6)周,术后8周Lysholm膝关节功能评分达到(90.5±1.7)分,随访终末期Lysholm评分达到(94.6±1.5)分。结论:采用关节镜下经髌内侧入路导入空心钉治疗前交叉韧带胫骨止点撕脱骨折,取得了良好的临床效果。     

低强度电刺激治疗大鼠股二头肌急性拉伤的实验研究

目的:采用低强度电刺激治疗股二头肌急性拉伤,观察其对肌肉损伤部位结构重塑的影响。方法:雄性SD大鼠36只,随机分为正常对照组和实验组,后者又依取材时间分为D0组、D7组、D7-20Hz组、D14组和D14-20Hz组,每组6只。各实验组采用电刺激使股二头肌强直收缩,同时以角速度960°.s-1伸膝摆腿反向拉伸,建立股二头肌急性拉伤动物模型。造模完成后,D7-20Hz组和D14-20Hz于动物造模后第5天开始进行20Hz电刺激治疗,每日2次,每次30分钟,间隔4小时,其余组继续喂养不做干预。正常对照组在实验开始当天,D0组、D7组、D7-20Hz组、D14组和D14-20Hz组分别在相应时间(实验当天,第7、7、14、14天)进行在体力矩测试,观测最大等长力矩值以及最优角度。然后处死动物,分离股二头肌,固定、切片、HE染色,光镜下观察股二头肌组织形态。结果:光镜观察可见,拉伤后第7天D7组肌纤维出现修复,但不成熟,肌纤维排列不严整,大小不一。经过电刺激治疗后,同期的D7-20Hz组新生的肌纤维更成熟,成簇排列,结构更严整,边界更清晰。第14天D14组和D14-20Hz组两组肌纤维基本修复。D0组关节最大等长力矩值下降至(0.246±0.026)Nm,与正常对照组(0.337±0.025)Nm比较有显著性差异(P<0.05);D7-20Hz组和D14-20Hz组关节最大等长力矩值分别与D7组和D14组比较均无显著性差异(P>0.05)。D0组最优角度为144.50°±3.71°,与正常对照组130.00°±3.54°比较存在显著性差异(P<0.01);D14组在120.00°±3.53°,与正常对照组比较有显著性差异(P<0.05)。经电刺激治疗后D14-20Hz最优角度出现在125.00°±3.53°,与D14组比较存在显著性差异(P<0.05)。结论:股二头肌急性拉伤后早期采用低强度电刺激治疗,可有效促进损伤肌肉结构重塑,虽不能在两周内明显提高关节最大等长力矩,但可优化关节力矩-角度关系。