Modified Biceps Suspension Procedure for Painful Glenohumeral Inferior Subluxation in Hemiplegic Stroke Patients: A Preliminary Study

Abstract

Shoulder pain is a common cause of pain in hemiplegic stroke patients. Inferior glenohumeral subluxation has been associated with shoulder pain in stroke patients. Various nonsurgical modalities have been tried to alleviate shoulder pain in this patient population but have not been able to provide a long-term symptom relief. In this study, we sought to report the early outcomes of a biceps tendon suspension-rotator interval imbrication procedure performed in 5 hemiplegic stroke patients with intractable shoulder pain. This procedure was a modification of a previously reported technique and involved looping the distal end of the proximal biceps long head tendon through transosseous tunnels in the bicipital groove and imbrication of the rotator interval. The mean pain VAS score was significantly improved from 8 preoperatively to 2 postoperatively. The mean American Shoulder and Elbow Surgeons score was also improved from 12 to 45. Four patients were “very satisfied” and 1 patient was “somewhat satisfied” with the surgical outcome. Our study demonstrates that biceps suspension-rotator interval imbrication procedure can be an effective treatment for hemiplegic patients with painful glenohumeral joint inferior subluxation.