Ramy Samargandi1,2, Waleed Abduh1,2, Luc Favard1,2, Christophe Le Du3, Philippe Collin4, Julien Berhouet5,6. 1. Service d'Orthopédie 1C, Centre Hospitalier Universitaire de Tours, Avenue de la République, 37044, Tours, France. 2. Faculté de Médecine, Université de Tours, PRES Centre-Val de Loire Université, Tours, France. 3. Clinique de l'Alliance, 1 Boulevard Alfred Nobel, 37540, Saint-Cyr-Sur-Loire, France. 4. Centre Hospitalier Privé Saint-Grégoire, 6 Boulevard de la Boutière, 35760, Saint-Grégoire, France. 5. Service d'Orthopédie 1C, Centre Hospitalier Universitaire de Tours, Avenue de la République, 37044, Tours, France. julien.berhouet@gmail.com. 6. Faculté de Médecine, Université de Tours, PRES Centre-Val de Loire Université, Tours, France. julien.berhouet@gmail.com.
Abstract
PURPOSE: To compare the clinical outcomes of self-locking T-tenotomy called "tomydesis" to three different techniques of tenodesis for lesions of the long head of the biceps tendon (LHBT) associated with rotator cuff tears. HYPOTHESIS: Tomydesis could provide similar clinical outcomes than the other LHBT tenodesis techniques. METHODS: This prospective multicentre study included 77 patients who underwent rotator cuff repair concomitant with one of four surgical techniques on the LHBT. All patients had a minimum of 6-month follow-up post-operatively. Outcomes were evaluated based on the Constant score, SSV, pain on visual analogue scale, biceps-specific pain and Popeye deformity on photographs. RESULTS: There was no difference for the pain at the biceps muscle belly (p = 0.58), the bicipital groove (p = 0.69) and during resisted supination (p = 0.53), as well as for muscle cramps (p = 0.09), VAS for pain (p = 0.12) and Popeye deformity (p = 0.18). There was more pain in resisted flexion in the tomydesis group (p = 0.032), and significantly better Constant scores and SSV (< 0.001) in the patients who underwent the double lasso loop technique, but non-repairable cuff tears were most frequent in the tomydesis group. CONCLUSIONS: Tomydesis might be a reliable alternative that combines advantages of tenodesis and tenotomy. It should be considered in cases of rotator cuff tears, whose repair and healing are the key for good functional outcomes. LEVEL OF EVIDENCE: II.
PURPOSE: To compare the clinical outcomes of self-locking T-tenotomy called "tomydesis" to three different techniques of tenodesis for lesions of the long head of the biceps tendon (LHBT) associated with rotator cuff tears. HYPOTHESIS: Tomydesis could provide similar clinical outcomes than the other LHBT tenodesis techniques. METHODS: This prospective multicentre study included 77 patients who underwent rotator cuff repair concomitant with one of four surgical techniques on the LHBT. All patients had a minimum of 6-month follow-up post-operatively. Outcomes were evaluated based on the Constant score, SSV, pain on visual analogue scale, biceps-specific pain and Popeye deformity on photographs. RESULTS: There was no difference for the pain at the biceps muscle belly (p = 0.58), the bicipital groove (p = 0.69) and during resisted supination (p = 0.53), as well as for muscle cramps (p = 0.09), VAS for pain (p = 0.12) and Popeye deformity (p = 0.18). There was more pain in resisted flexion in the tomydesis group (p = 0.032), and significantly better Constant scores and SSV (< 0.001) in the patients who underwent the double lasso loop technique, but non-repairable cuff tears were most frequent in the tomydesis group. CONCLUSIONS: Tomydesis might be a reliable alternative that combines advantages of tenodesis and tenotomy. It should be considered in cases of rotator cuff tears, whose repair and healing are the key for good functional outcomes. LEVEL OF EVIDENCE: II.
Entities:
Keywords:
Biceps tenodesis; Biceps tenotomy; Long head of biceps; Rotator cuff repair; T-tenotomy; Tomydesis
Authors: Pascal Boileau; François Baqué; Laure Valerio; Philip Ahrens; Christopher Chuinard; Christophe Trojani Journal: J Bone Joint Surg Am Date: 2007-04 Impact factor: 5.284
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