Arthroscopic diagnosis of long head of biceps tendon instability in refractory anterior shoulder pain: A comparison study between pulley tear and non-tear lesions

Jo Ting Kao, Chih Hao Chiu, Kuo Yau Hsu, Shih Sheng Chang, Yi Sheng Chan, Alvin Chao Yu Chen*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

6 Scopus citations

Abstract

Background: Long head of the biceps tendon (LHBT) instability and biceps reflection pulley (BRP) lesions are common cause of refractory anterior shoulder pain. We described a technique using dynamic arthroscopy to determine associated intraarticular pathologies. Methods: Patients with refractory anterior shoulder pain and arthroscopically-diagnosed LHBT instability were enrolled. LHBT instability and the integrity of BRP and concomitant intra-articular lesions were investigated by ramp test. Demographics and arthroscopic findings were compared between patients with and without BRP tear. Results: Forty patients were enrolled. BRP tear was noted in 25 patients (group A) and superior glenohumeral ligament (SGHL) insufficiency through ramp test in 15 patients (group B). Concomitant intraarticular pathologies were noted in 27 patients, including 19 in group A (76%) and eight in group B (53%), without significant group-wise difference (p = 0.138). The incidence of articular-side subscapularis tear was significantly higher in group A (p = 0.021), and those of the other intraarticular pathologies were similar between groups A and B. Fraying at the articular side of the subscapularis and supraspinatus tendons was frequent in group B, without difference of incidence as compared to group A (p = 0.5 and p = 0.084, respectively). Conclusions: LHBT instability was a common disorder in patients with refractory shoulder pain. In those patients, dynamic assessment of BRP lesions and SGHL insufficiency and meticulous survey of associated intra-articular pathologies, including subscapularis tear are necessary for making accurate diagnosis and treatment decision.

Original languageEnglish
Pages (from-to)163-169
Number of pages7
JournalBiomedical Journal
Volume46
Issue number1
DOIs
StatePublished - 02 2023

Bibliographical note

Copyright © 2022 Chang Gung University. Published by Elsevier B.V. All rights reserved.

Keywords

  • Anterior shoulder pain
  • Arthroscopy
  • Biceps tendon
  • Pulley lesion
  • Ramp test
  • Shoulder Joint/surgery
  • Humans
  • Shoulder Pain/diagnosis
  • Arthroscopy/adverse effects
  • Tendons/surgery
  • Muscle, Skeletal

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