scholarly journals Functional anatomy of the superior glenohumeral and coracohumeral ligaments and the subscapularis tendon in view of stabilization of the long head of the biceps tendon

2010 ◽  
Vol 19 (1) ◽  
pp. 58-64 ◽  
Author(s):  
Ryuzo Arai ◽  
Tomoyuki Mochizuki ◽  
Kumiko Yamaguchi ◽  
Hiroyuki Sugaya ◽  
Masahiko Kobayashi ◽  
...  
Keyword(s):  
Biceps Tendon ◽  
Functional Anatomy ◽  
Subscapularis Tendon ◽  
Long Head

scholarly journals Yergason's Test: Discrepancies in Description and Implications for Diagnosing Biceps Subluxation

2008 ◽  
Vol 3 (4) ◽  
pp. 143-147 ◽  
Author(s):  
Robert W. Pettitt ◽  
Scott R. Sailor ◽  
Gary Lentell ◽  
Cary Tanner ◽  
Steven R. Murray
Keyword(s):  
Biceps Tendon ◽  
Athletic Trainers ◽  
Instructional Materials ◽  
Positive Sign ◽  
Subscapularis Tendon ◽  
Bicipital Groove ◽  
Certification Examination ◽  
Wide Range ◽  
Long Head ◽  
Board Of Certification

Yergason described the case of a woman with bicipital pain that was confirmed with isolated forearm supination. Since publication of this respective case report in 1931, orthopedic assessment textbooks have provided a wide range of descriptions for Yergason's Test and what a positive sign implicates. Vast differences in hand placement, along with the vernacular for shoulder, forearm, and elbow motions, have been associated with Yergason's Test. Many authors associate pain with the maneuver as a diagnosis for a rupture of the transverse humeral ligament (THL) and subsequent subluxation of the long head of the biceps tendon (LBT). Interestingly, many now believe that the THL is not a distinct ligament; rather, support of the LBT within the bicipital groove occurs from a fibrous extension of the subscapularis tendon. Thus, evaluation of the subscapularis when a subluxing LBT is suspected is critical. The discrepancies of Yergason's Test among orthopedic assessment textbooks shall be summarized along with a brief review of contemporary views on how to clinically evaluate the subluxing LBT. Until consensus is reached on hand placement and joint movements to provoke subluxation of the LBT, Yergason's Test should be removed from instructional materials and the Board of Certification examination for athletic trainers, if applicable.

Predictive factors of long head of the biceps tendon disorders—the bicipital groove morphology and subscapularis tendon tear

2016 ◽  
Vol 25 (3) ◽  
pp. 384-389 ◽  
Author(s):  
Atsushi Urita ◽  
Tadanao Funakoshi ◽  
Toraji Amano ◽  
Yuichiro Matsui ◽  
Daisuke Kawamura ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Biceps Tendon ◽  
Subscapularis Tendon ◽  
Bicipital Groove ◽  
Tendon Tear ◽  
Subscapularis Tendon Tear ◽  
Long Head

scholarly journals Superior labrum almost always tears following subscapularis injuries

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0006
Author(s):  
Mehmet Çetinkaya ◽  
Muhammet Baybars Ataoğlu ◽  
Mustafa Özer ◽  
Tacettin Ayanoğlu ◽  
Ahmet Yiğit Kaptan ◽  
...  
Keyword(s):  
Shoulder Arthroscopy ◽  
Biceps Tendon ◽  
Slap Lesion ◽  
Subscapularis Tendon ◽  
Strongly Correlated ◽  
Subscapularis Tear ◽  
Slap Lesions ◽  
Superior Labrum ◽  
Medial Support ◽  
Long Head

Purpose and Hypothesis: The subscapularis tendon is the major medial support of the long head of biceps tendon (LHBT). Thus, tears of subscapularis may cause biceps tendon subluxation or dislocation. A subluxated biceps tendon may cause a superior labrum injury because of the changed direction of the biceps tendon pulling vector. The purpose of this study is to express the frequency of superior labrum anterior posterior (SLAP) lesions accompanying subscapularis tears. Methods: The digital files of 2010 patients who underwent shoulder arthroscopy were reviewed retrospectively. 141 videos of 141 patients with subscapularis tear were examined in terms of superior labrum and biceps tendon injuries by one of the authors in this study. The results were compared with those of all the 2010 patients who underwent shoulder arthroscopy for any reason. The statistical analysis was made with a statistics programme by the Independent Samples T-Test. Results: There were 113 videos on which the superior labrum and LHBT could be examined precisely. Mean age was 57.8 and 66% of the patients were female. 96.4% of the 113 patients were having a SLAP lesion. 10.6% of those were SLAP I and 89.4% were SLAP II lesion. Out of 2010 patients, the SLAP lesion ratio was 32.2% of which 4.9% were SLAP I. That difference between the patients with and without subscapularis tear was statistically significant. Conclusions: Following the loss of medial support, the LHBT and its pulling vector subluxate anteriorly resulting in a tear of the superior labrum from anterior to posterior. In this study, SLAP lesions were strongly correlated with subscapularis tears as well. Furthermore, the synovial hypertrophy initiated after a superior labrum pathology at superior aspect of the glenoid spreads over the LHBT. An inflamed LHBT firstly degenerates, and then ruptures. According to this study, tears of subscapularis should be repaired when encountered in order to prevent the upcoming secondary intra-articular disorders. [Figure: see text]

Predicting the clinically significant subscapularis tendon tear: malposition and tear of the long head of the biceps tendon on shoulder magnetic resonance imaging

2020 ◽  
pp. 028418512098001
Author(s):  
Bo Ra Kim ◽  
Jaehyung Lee ◽  
Joong Mo Ahn ◽  
Yusuhn Kang ◽  
Eugene Lee ◽  
...  
Keyword(s):  
Biceps Tendon ◽  
Control Group ◽  
Subscapularis Tendon ◽  
Study Group ◽  
Mr Images ◽  
Tendon Tear ◽  
Partial Thickness ◽  
Subscapularis Tendon Tear ◽  
Clinically Significant ◽  
Long Head

Background The diagnostic accuracy of magnetic resonance imaging (MRI) is low for detecting a subscapularis tendon tear. Purpose To identify MRI findings that may predict the presence of a clinically significant subscapularis tendon tear requiring surgical repair. Material and Methods We reviewed shoulder MR images of patients who had undergone arthroscopic rotator cuff repair at our institution between June 2018 and May 2019. Patients were divided into two groups: the study group (n = 51), with an intermediate- to high-grade partial thickness tear of the subscapularis tendon suspected on preoperative MRI and intermediate or higher grade of the tendon tear proven on arthroscopy; and the control group (n = 18), with an intermediate- to high-grade partial thickness tear of the subscapularis tendon suspected on preoperative MRI but no tear or low-grade partial thickness tear of the tendon shown on arthroscopy. Preoperative MR images were retrospectively evaluated by two readers for the size of the subscapularis tendon tear, bone reactions at the lesser tuberosity, and long head of the biceps tendon (LHBT) pathology. Results The subscapularis tendon tear measured by reader 2 was larger in the study group than in the control group. The prevalence of a tear ( P = 0.006 for reader 1; P = 0.011 for reader 2) and malposition ( P < 0.001 for both readers) of the LHBT were significantly greater in the study group. Conclusion A tear and malposition of the LHBT on MR images may predict the presence of a clinically significant subscapularis tendon tear.

scholarly journals Association of high sensitivity C-reactive protein with tearing of the long head of the biceps tendon

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Ji-Yong Gwark ◽  
Hyung Bin Park
Keyword(s):  
Biceps Tendon ◽  
High Sensitivity ◽  
Subscapularis Tendon ◽  
C Reactive Protein ◽  
Tendon Tear ◽  
Reactive Protein ◽  
Subscapularis Tendon Tear ◽  
Post Test ◽  
Hs Crp ◽  
Long Head

Abstract Background This study proposed to investigate whether high-sensitivity C-reactive protein (hs-CRP) is an independent risk factor for long head of biceps tendon (LHBT) tear and whether hs-CRP can increase accuracy in diagnosing LHBT tear. Methods This study involved 582 shoulders of 557 consecutive patients who received arthroscopic examinations at the authors’ institution between January 2010 and July 2018. The strengths of associations between LHBT tear and various factors were determined by calculating the odds ratios (ORs), with 95% confidence intervals (CIs), using logistic regression analyses. The studied variables were demographic, physical, social, metabolic, comorbidity, hs-CRP, and pain on a visual analog scale (VAS) factors, as well as those related to rotator cuff tear (RCT). Significant factors in the multivariable logistic analysis were evaluated to determine their diagnostic values, including their likelihood ratios and post-test probabilities for LHBT tear. Results In the multivariable analysis, five variables were significant: age, retraction degree of Patte, subscapularis tendon tear, hs-CRP > 1 mg/L, and pain VAS (p ≤ 0.01). The best combination of determinations for diagnosing LHBT tear, which yielded a strong positive likelihood ratio of 19.07 and a high post-test probability of 96%, was age ≥ 67 years, subscapularis tendon tear, grade of Patte ≥2, hs-CRP > 1, and pain VAS ≥ 7. Conclusions Serum hs-CRP > 1 mg/L is an independent risk factor for LHBT tear, along with the expected risk factors of age, subscapularis tendon tear, retraction degree of Patte, and pain VAS. Serum hs-CRP > 1 mg/L increases the diagnostic accuracy for LHBT tear. Level of evidence Level IV, Clinical case series.

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