Tenodesis of long biceps tendon in it’s pathology

Abstract

One of the causes of pain and dysfunction of the shoulder joint may be inflammation or injury of intraarticular or extraarticular part of long head of the biceps (LHB). Different versions ofLHB pathology are the indication for surgical treatment, namely to tenodesis or tenotomy of LHB. There are many methods and locations for LHB tendon fixation, but consensus on their use is absent.Objective: To determine the best method and location for LHB fixation taking into considerations types of it’s pathology. Methods: A retrospective analysis of treatment in 37 patients (26 men, 11 women from 18 to 79 years) with various types of LHB tendon pathology in the period from 2009 to 2015.In the preoperative period, in all patients clinical loading provocative Speed, O'Brien, Yergasson test provided, humeral joint radiography and MRI studies performed. Options for surgical treatment were: tenotomy, tenodesis with anchor fixation, tenodesis with interferential screws, subpectoral fixation using Endobutton system and subpectoral tenodesiswith transposal fixation. Results: performing choice of surgical treatment in biceps pathology, besides the morphology of LHB tendon injury, one must take into consideration the patient’s age, level of physical activity and work, and the associated pathology of humeral joint. Application of biceps tenotomy in patients older than 50 years with low physical activity and non intensive the labor activity allows to reduce the operation time, intraoperative injury and to get good results without significant reduction in functional outcomes. Application of subpectoral tenodesis of LHB tendon with Endobutton system and transossal fixation results in the best functional outcome.