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Comparison between arthroscopic simple biceps tenotomy & anchor tenotomy technique regarding clinical outcomes & ultrasound assessment
This research compares two surgical techniques for addressing pathologies of the long head of the biceps (LHB) tendon: arthroscopic simple biceps tenotomy and anchor tenotomy. The LHB tendon, originating from the supraglenoid tubercle, plays a critical role in forearm supination, elbow flexion, and shoulder abduction. Pathologies affecting this tendon often cause significant shoulder pain, with surgical options including tenotomy and tenodesis. While simple tenotomy is quick and avoids implant complications, it may result in cosmetic deformities like the "Popeye" sign and muscle cramps. Anchor tenotomy, a novel technique, aims to minimize these issues by preventing the Popeye deformity. This study employs a prospective randomized double-blinded controlled trial design at Assiut University Hospitals, involving 72 patients with LHB pathologies such as tendinitis, rotator cuff tears, and subacromial impingement. Exclusion criteria include prior tenodesis or neuromuscular diseases. Clinical outcomes will be assessed using functional scores (e.g., Oxford Shoulder Score), ultrasound evaluation of tendon positioning, and follow-up examinations at intervals up to one year post-surgery. The primary outcome focuses on the presence of the Popeye deformity, while secondary outcomes include postoperative shoulder function and tendon distalization measured via ultrasound. This research aims to provide evidence-based insights into the comparative effectiveness of these two techniques in improving clinical outcomes and minimizing complications.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arthroscopic simple Biceps tenotomy | Experimental | This group undergoes a straightforward arthroscopic procedure to release the LHB tendon. The technique is quick and avoids the need for implants or prolonged rehabilitation. However, it carries a risk of cosmetic deformities, such as the "Popeye" sign, and potential biceps muscle cramps postoperatively. | |
| anchor tenotomy technique | Experimental | This group undergoes a novel anchor-based tenotomy technique. The procedure aims to prevent the Popeye deformity by anchoring the released tendon in a specific position. While technically more complex than simple tenotomy, it is designed to improve cosmetic outcomes and potentially reduce postoperative complications. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Arthroscopic Simple Biceps Tenotomy: | Procedure | Arthroscopic Simple Biceps Tenotomy: This procedure involves an arthroscopic release of the LHB tendon from its attachment at the superior glenoid labrum. It is a quick and simple technique that does not require implants or extensive postoperative rehabilitation. The main drawback is the potential for developing a "Popeye" deformity, where the biceps muscle bulges due to distal migration, as well as occasional muscle cramps. |
| Measure | Description | Time Frame |
|---|---|---|
| evaluate for popeye sign after arthroscopic simple biceps tenotomy vs anchor technique tenotomy | clinical evaluation of shoulder function postoperative by dynamometer & US assessment of LHB tendon distalization after LHB tenotomy . Remove | 1 year |
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Inclusion Criteria:
Biceps tendinitis Rotator cuff tears Subacromial impengiment Instability & traumatic causes
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| ahmed S shehata, bachelor of medicine | Contact | 01010527046 | Ahmed.15248388@med.aun.edu.eg |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Assiut University | Asyut | Egypt |
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| Anchor Tenotomy Technique: | Procedure | Anchor Tenotomy Technique: This is a novel arthroscopic method where, after releasing the LHB tendon, it is anchored in place to prevent distal migration. The goal of this technique is to avoid the Popeye deformity and improve cosmetic outcomes while maintaining functional integrity. This procedure is technically more challenging and may involve a longer operative time compared to simple tenotomy. |
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