Abstract

AZEVEDO, Clara  and  VINGA, Susana. Reinserção artroscópica do supra-espinhoso: O que fazer com a longa porção do bicípite braquial? Estudo prospetivo de 42 doentes. Rev. Port. Ortop. Traum. [online]. 2012, vol.20, n.1, pp.45-56. ISSN 1646-2122.

Introduction: Long head of biceps brachii lesions in association with supraspinatus tendon tears are very frequent, but there is no consensus on when and how to deal with them. Purpose: to determine if treating the long head of biceps, when repairing a supraspinatus tendon tear, has a repercussion on: the global functional outcome of the shoulder; the incidence of a Popeye sign; bicipital pain; and patient satisfaction. Methods: 42 patients were divided in three groups: 1. No procedure performed on the long head of biceps brachii (8); 2. Tenotomy (12); 3. Tenodesis (22); and compared for: functional status of the shoulder preoperatively and at 6 months postoperative [Simple Shoulder Test (SST); Constant-Murley score (CM)]; presence of a Popeye sign, or bicipital pain; patient satisfaction. Statistical analysis: group comparison tests; IBM® SPSS® Statistics 19. Level of evidence: Level II  Results: There was no significant difference between the three groups (p>0,05) considering the initial variables (age, sex, occupation, workman’s compensation, long head of bíceps brachii lesion, supraspinatus tendon tear, and preoperative SST and CM) and the SST and CM improval at 6 months. In the tenotomy group, there was one Popeye sign (9.1%), and a higher percentage of bicipital pain (18.1%) than in the tenodesis group (9.1%), but this was not statistically significant. Patient satisfaction was lower in the group with no procedure performed on the long head of biceps brachii (37.5%, CI95%=[8.5%;75.5%]) than in the tenotomy and tenodesis groups (97.1%, CI95%=[84.7%;99.9%]), statistically significant (p-value=3.7E-4, Fisher’s exact test). Conclusions: Long head of bíceps brachii procedures in supraspinatus tendon tear repairs do not have a repercussion on the functional outcome of the shoulder at 6 months. However, not performing any procedure results in a lower satisfaction rate, compared with tenotomy or tenodesis. It might be advisable to always perform either a tenotomy, or a tenodesis, when repairing a supraspinatus tendon tear.

Keywords : Long head of bíceps brachii; tenotomy; tenodesis; supraspinatus; arthroscopy.

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