Effectiveness of arthroscopic long head of biceps tendon transposition combined with Swivelock anchor double fixation for massive and irreparable rotator cuff tears_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

KANG Yunkang ,  GUO Biao , XU Jian , BI Wenzhi , MA Wei , YANG Dongqiang , CUI Honglin , FU Pengfei , LIU Yijun , TIAN Jinxiang , LIU Yifeng

Department of Orthopedics, Fuyang People’s Hospital Affiliated to Anhui Medical University (Fuyang City People’s Hospital), Fuyang Anhui, 236000, P. R. China;

Corresponding author：

GUO Biao, Email: happygb@126.com

Keywords：

Arthroscopy; massive rotator cuff tear; irreparable rotator cuff tear; long head of biceps tendon transposition

DOI：

10.7507/1002-1892.202207102

Video：

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Objective To investigate the effectiveness of arthroscopic long head of biceps tendon (LHBT) transposition combined with Swivelock anchor double fixation in treatment of massive and irreparable rotator cuff tears. Methods Between June 2019 and November 2021, 25 patients with massive and irreparable rotator cuff tears were treated by arthroscopic LHBT transposition combined with Swivelock anchor double fixation. There were 12 males and 13 females. The age ranged from 47 to 74 years (mean, 62.4 years). The disease duration ranged from 1 to 62 months (median, 7 months). The rotator cuff tears were classified as Hamada grade 2 in 25 cases and Goutallier grade 1 in 2 cases, grade 2 in 22 cases, and grade 3 in 1 case. Pre- and post-operative shoulder range of motion (ROM), visual analogue scale (VAS) score, University of California Los Angeles (UCLA) score, and Constant-Murley score were recorded. Postoperative complications were observed. The reconstructed tissue integrity was confirmed by MRI. Results All operations were successfully completed. The operation time was 120-330 minutes (mean, 189.6 minutes). All incisions healed by first intention. All patients were followed up 10-36 months (mean, 22.0 months). At last follow-up, the ROM in forward flexion, abduction, and external rotation, VAS score, UCLA score, and Constant-Murley score were superior to those before operation, and the differences were significant (P<0.05). According to UCLA scoring standard, shoulder joint function was rated as excellent in 5 cases, good in 18 cases, and poor in 2 cases, with an excellent and good rate of 92.0%. No other complications occurred except shoulder joint adhesion in 2 cases. At last follow-up, MRI examination showed no retear of rotator cuff, and LHBT was intact. Conclusion For massive and irreparable rotator cuff tears, arthroscopic LHBT transposition combined with Swivelock anchor double fixation can increase the force of pressing the humeral head, effectively relieve the pain, improve the ROM of joints, maximize the recovery of shoulder function, and do not increase the number of anchor nails.

Citation： KANG Yunkang, GUO Biao, XU Jian, BI Wenzhi, MA Wei, YANG Dongqiang, CUI Honglin, FU Pengfei, LIU Yijun, TIAN Jinxiang, LIU Yifeng. Effectiveness of arthroscopic long head of biceps tendon transposition combined with Swivelock anchor double fixation for massive and irreparable rotator cuff tears. Chinese Journal of Reparative and Reconstructive Surgery, 2022, 36(12): 1459-1464. doi: 10.7507/1002-1892.202207102 Copy

1.	郑小龙, 唐康来. 巨大肩袖撕裂治疗的研究进展. 中国修复重建外科杂志, 2021, 35(1): 8-13.
2.	Cartucho A. Tendon transfers for massive rotator cuff tears. EFORT Open Rev, 2022, 7(6): 404-413.
3.	Berth A, Neumann W, Awiszus F, et al. Massive rotator cuff tears: functional outcome after debridement or arthroscopic partial repair. J Orthop Traumatol, 2010, 11(1): 13-20.
4.	Kany J. Tendon transfers in rotator-cuff surgery. Orthop Traumatol Surg Res, 2020, 106(1S): S43-S51.
5.	Muench LN, Kia C, Williams AA, et al. High clinical failure rate after latissimus dorsi transfer for revision massive rotator cuff tears. Arthroscopy, 2020, 36(1): 88-94.
6.	El-Shaar R, Soin S, Nicandri G, et al. Superior capsular reconstruction with a long head of the biceps tendon autograft: A cadaveric study. Orthop J Sports Med, 2018, 6(7): 2325967118785365. doi: 10.1177/2325967118785365.
7.	Ortiz JA. Clinical outcomes in breast reconstruction patients using a sterile acellular dermal matrix allograft. Aesthetic Plast Surg, 2017, 41(3): 542-550.
8.	Wall B, Nové-Josserand L, O’Connor DP, et al. Reverse total shoulder arthroplasty: a review of results according to etiology. J Bone Joint Surg (Am), 2007, 89(7): 1476-1485.
9.	Boutsiadis A, Chen S, Jiang C, et al. Long head of the biceps as a suitable available local tissue autograft for superior capsular reconstruction: “The Chinese Way”. Arthrosc Tech, 2017, 6(5): e1559-e1566.
10.	尚西亮, 吕婧仪, 陈疾忤, 等. 关节镜下肱二头肌长头腱转位固定辅助替代上关节囊重建(Chinese Way)修补巨大及不可修复肩袖撕裂的临床疗效. 中国运动医学杂志, 2019, 38(8): 652-657.
11.	余电柏, 韦积华, 蓝常贡, 等. 关节镜下“Chinese way”两种术式修补巨大及不可修复肩袖撕裂的临床研究. 微创医学, 2021, 16(5): 624-629.
12.	冯星, 陈长健, 杨梁. 关节镜下肩袖修复中肱二头肌长头肌腱固定术后近端切断与否的临床疗效比较. 中国修复重建外科杂志, 2022, 36(7): 845-852.
13.	武洵, 严清, 孙俊, 等. 单排锚钉结合“Chinese way”技术治疗大型肩袖撕裂的临床疗效. 实用骨科杂志, 2021, 27(4): 359-362.
14.	Zumstein MA, Jost B, Hempel J, et al. The clinical and structural long-term results of open repair of massive tears of the rotator cuff. J Bone Joint Surg (Am), 2008, 90(11): 2423-2431.
15.	Gerber C, Fuchs B, Hodler J. The results of repair of massive tears of the rotator cuff. J Bone Joint Surg (Am), 2000, 82(4): 505-515.
16.	Hamada K, Fukuda H, Mikasa M, et al. Roentgenographic findings in massive rotator cuff tears. A long-term observation. Clin Orthop Relat Res, 1990, (254): 92-96.
17.	Goutallier D, Postel JM, Gleyze P, et al. Influence of cuff muscle fatty degeneration on anatomic and functional outcomes after simple suture of full-thickness tears. J Shoulder Elbow Surg, 2003, 12(6): 550-554.
18.	Shang X, Chen J, Chen S. A meta-analysis comparing tenotomy and tenodesis for treating rotator cuff tears combined with long head of the biceps tendon lesions. PLoS One, 2017, 12(10): e0185788. doi: 10.1371/journal.pone.0185788.
19.	Kitridis D, Yiannakopoulos C, Sinopidis C, et al. Superior capsular reconstruction of the shoulder using the long head of the biceps tendon: A systematic review of surgical techniques and clinical outcomes. Medicina (Kaunas), 2021, 57(3): 229. doi: 10.3390/medicina57030229.
20.	Adrian SC, Field LD. Biceps transposition for biological superior capsular reconstruction. Arthrosc Tech, 2020, 9(6): e841-e846.
21.	Kim JH, Lee HJ, Park TY, et al. Preliminary outcomes of arthroscopic biceps rerouting for the treatment of large to massive rotator cuff tears. J Shoulder Elbow Surg, 2021, 30(6): 1384-1392.
22.	Kocaoglu B, Firatli G, Ulku TK. Partial rotator cuff repair with superior capsular reconstruction using the biceps tendon is as effective as superior capsular reconstruction using a tensor fasciae latae autograft in the treatment of irreparable massive rotator cuff tears. Orthop J Sports Med, 2020, 8(6): 2325967120922526. doi: 10.1177/2325967120922526.
23.	Gurnani N, van Deurzen DF, Janmaat VT, et al. Tenotomy or tenodesis for pathology of the long head of the biceps brachii: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc, 2016, 24(12): 3765-3771.
24.	Hermanowicz K, Góralczyk A, Malinowski K, et al. Long head biceps tendon-Natural patch for massive irreparable rotator cuff tears. Arthrosc Tech, 2018, 7(5): e473-e478.
25.	Kim DS, Yeom J, Park J, et al. L-shape superior capsular augmentation technique using biceps tendon: The biceps L-shape shifting technique. Arthrosc Tech, 2020, 9(6): e703-e709.
26.	Dierickx C, Ceccarelli E, Conti M, et al. Variations of the intra-articular portion of the long head of the biceps tendon: a classification of embryologically explained variations. J Shoulder Elbow Surg, 2009, 18(4): 556-565.

1. 郑小龙, 唐康来. 巨大肩袖撕裂治疗的研究进展. 中国修复重建外科杂志, 2021, 35(1): 8-13.
2. Cartucho A. Tendon transfers for massive rotator cuff tears. EFORT Open Rev, 2022, 7(6): 404-413.
3. Berth A, Neumann W, Awiszus F, et al. Massive rotator cuff tears: functional outcome after debridement or arthroscopic partial repair. J Orthop Traumatol, 2010, 11(1): 13-20.
4. Kany J. Tendon transfers in rotator-cuff surgery. Orthop Traumatol Surg Res, 2020, 106(1S): S43-S51.
5. Muench LN, Kia C, Williams AA, et al. High clinical failure rate after latissimus dorsi transfer for revision massive rotator cuff tears. Arthroscopy, 2020, 36(1): 88-94.
6. El-Shaar R, Soin S, Nicandri G, et al. Superior capsular reconstruction with a long head of the biceps tendon autograft: A cadaveric study. Orthop J Sports Med, 2018, 6(7): 2325967118785365. doi: 10.1177/2325967118785365.
7. Ortiz JA. Clinical outcomes in breast reconstruction patients using a sterile acellular dermal matrix allograft. Aesthetic Plast Surg, 2017, 41(3): 542-550.
8. Wall B, Nové-Josserand L, O’Connor DP, et al. Reverse total shoulder arthroplasty: a review of results according to etiology. J Bone Joint Surg (Am), 2007, 89(7): 1476-1485.
9. Boutsiadis A, Chen S, Jiang C, et al. Long head of the biceps as a suitable available local tissue autograft for superior capsular reconstruction: “The Chinese Way”. Arthrosc Tech, 2017, 6(5): e1559-e1566.
10. 尚西亮, 吕婧仪, 陈疾忤, 等. 关节镜下肱二头肌长头腱转位固定辅助替代上关节囊重建(Chinese Way)修补巨大及不可修复肩袖撕裂的临床疗效. 中国运动医学杂志, 2019, 38(8): 652-657.
11. 余电柏, 韦积华, 蓝常贡, 等. 关节镜下“Chinese way”两种术式修补巨大及不可修复肩袖撕裂的临床研究. 微创医学, 2021, 16(5): 624-629.
12. 冯星, 陈长健, 杨梁. 关节镜下肩袖修复中肱二头肌长头肌腱固定术后近端切断与否的临床疗效比较. 中国修复重建外科杂志, 2022, 36(7): 845-852.
13. 武洵, 严清, 孙俊, 等. 单排锚钉结合“Chinese way”技术治疗大型肩袖撕裂的临床疗效. 实用骨科杂志, 2021, 27(4): 359-362.
14. Zumstein MA, Jost B, Hempel J, et al. The clinical and structural long-term results of open repair of massive tears of the rotator cuff. J Bone Joint Surg (Am), 2008, 90(11): 2423-2431.
15. Gerber C, Fuchs B, Hodler J. The results of repair of massive tears of the rotator cuff. J Bone Joint Surg (Am), 2000, 82(4): 505-515.
16. Hamada K, Fukuda H, Mikasa M, et al. Roentgenographic findings in massive rotator cuff tears. A long-term observation. Clin Orthop Relat Res, 1990, (254): 92-96.
17. Goutallier D, Postel JM, Gleyze P, et al. Influence of cuff muscle fatty degeneration on anatomic and functional outcomes after simple suture of full-thickness tears. J Shoulder Elbow Surg, 2003, 12(6): 550-554.
18. Shang X, Chen J, Chen S. A meta-analysis comparing tenotomy and tenodesis for treating rotator cuff tears combined with long head of the biceps tendon lesions. PLoS One, 2017, 12(10): e0185788. doi: 10.1371/journal.pone.0185788.
19. Kitridis D, Yiannakopoulos C, Sinopidis C, et al. Superior capsular reconstruction of the shoulder using the long head of the biceps tendon: A systematic review of surgical techniques and clinical outcomes. Medicina (Kaunas), 2021, 57(3): 229. doi: 10.3390/medicina57030229.
20. Adrian SC, Field LD. Biceps transposition for biological superior capsular reconstruction. Arthrosc Tech, 2020, 9(6): e841-e846.
21. Kim JH, Lee HJ, Park TY, et al. Preliminary outcomes of arthroscopic biceps rerouting for the treatment of large to massive rotator cuff tears. J Shoulder Elbow Surg, 2021, 30(6): 1384-1392.
22. Kocaoglu B, Firatli G, Ulku TK. Partial rotator cuff repair with superior capsular reconstruction using the biceps tendon is as effective as superior capsular reconstruction using a tensor fasciae latae autograft in the treatment of irreparable massive rotator cuff tears. Orthop J Sports Med, 2020, 8(6): 2325967120922526. doi: 10.1177/2325967120922526.
23. Gurnani N, van Deurzen DF, Janmaat VT, et al. Tenotomy or tenodesis for pathology of the long head of the biceps brachii: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc, 2016, 24(12): 3765-3771.
24. Hermanowicz K, Góralczyk A, Malinowski K, et al. Long head biceps tendon-Natural patch for massive irreparable rotator cuff tears. Arthrosc Tech, 2018, 7(5): e473-e478.
25. Kim DS, Yeom J, Park J, et al. L-shape superior capsular augmentation technique using biceps tendon: The biceps L-shape shifting technique. Arthrosc Tech, 2020, 9(6): e703-e709.
26. Dierickx C, Ceccarelli E, Conti M, et al. Variations of the intra-articular portion of the long head of the biceps tendon: a classification of embryologically explained variations. J Shoulder Elbow Surg, 2009, 18(4): 556-565.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness of arthroscopic long head of biceps tendon transposition combined with Swivelock anchor double fixation for massive and irreparable rotator cuff tears

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