• Clinics in Shoulder and Elbow
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• v.1 no.2
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• pp.154-159
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• 1998

Medial dislocation of the long head of the biceps brachii is a rare condition that usually occurs in association with tears of the subscapularis, chronic impingement, capsular defects or a fracture of the lesser tuberosity. Less commonly, a biceps tendon dislocation may occur after an acute traumatic event. Following a dislocation, the biceps tendon will assume either an intra- or extra-articular position depending on whether or not the subscapularis tendon detaches from its humeral insertion. Magnetic resonance imaging has been found to provide valuable information concerning the location of the biceps tendon and the integrity of the subscapularis tendon. We present a patient with a traumatic dislocation of the biceps brachii tendon in which the diagnosis remained elusive for an extended period of time. In this case, he was evaluated using MRI and reconstruction was performed by restoring the tendon to its anatomical position.

• Clinics in Shoulder and Elbow
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• v.7 no.1
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• pp.5-9
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• 2004

Purpose: To identify associated findings in glenohumeral joint in rotator cuff tear and evaluate its clinical significance, we examined minor and major changes during arthroscopic or mini open repair. Materials & Methods: We reviewed 66 patients of rotator cuff tear treated from March, 2001 to January, 2004. Of 38 cases of small to medium tear, average age was 53 years old and involved in dominant arm in 27 cases. Of 28 cases of large to massive tear, average age was 58 years old and involved in dominant arm in 26 cases. Minor and major associated changes of the glenohumeral joint were evaluated in the tendon of biceps long head, biceps pulley, cartilage of the glenoid and humeral head, labrum and synovium. Results: Minor changes in biceps tendon were in 35% of cases, biceps pulley in 18%, cartilage of humeral head in 27%, cartilage of glenoid in 18%, labrum in 38%, and synovium in 42%. Major changes in biceps tendon were in 6% of cases, biceps pulley in 35%, arthritis of humeral head in 3%, arthritis of glenoid in 2%, labrum in 6%, and synovium in 21 %. Major changes in biceps tendon were 5% in Group I and 7% in Group Ⅱ(p>0.05) and in biceps pulley, 18% and 57% in each (P<0.05). Minor changes of arthritis were prevalent in glenoid cartilage and major changes were more prevalent in humeral head. There were no differences in minor changes of labrum and synovium, but major changes were more prevalent in Group Ⅱ. Conclusion: The prevalence of intraarticular associated changes of rotator cuff tear were 63% in synovium, 54% in labrum, 53% in biceps pulley, 41% in biceps tendon, 30% in humeral head and 20% in glenoid cartilage in order. Major changes of biceps pulley, humeral head, labrum and synovium were more prevalent in Group Ⅱ.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2008.03a
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• pp.165-165
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• 2008

A 27-year-old, right-hand-dominant woman with a posttraumatic anterior shoulder dislocation 3 months earlier after traYc accident presented because of pain and limited range of motion in the right shoulder. On physical examination, the patient had negative instability tests and a sulcus sign. On arthroscopic examination, a bifurcate long biceps tendon with two limbs was observed about 1 cm distal to the origin in the supraglenoid tubercle. We found no evidence of a tear in the long biceps tendon on probing, and the margin of each limb was smooth and round. Although this anatomic variant may be benign, its presence might be associated with other shoulder pathology. It is interesting to speculate whether the aberrant biceps anatomy in our patient contributed to transfer of injury at dislocation to the rotator cuff rather than to the classic anterior-inferior capsulolabral complex. In addition, recognition of the described anatomic variant on arthroscopy can aid the shoulder surgeon in focusing treatment on the actual pathology.

• Clinics in Shoulder and Elbow
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• v.14 no.2
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• pp.236-241
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• 2011

Purpose: To report the usefulness of dynamic ultrasonography in subluxation of the long head of the biceps tendon, which is difficult to detect with static imaging such as plain radiography, static sonography, MRI and in a subtle physical examination. Materials and Methods: Two male patients suffered from subluxation of the long head of the biceps. This difficult diagnosis? was managed by surgery (biceps soft tissue tenodesis) with the aid of dynamic ultrasonography. At final follow up, we evaluated patients' symptoms and functional outcomes using KSS, UCLA and ASES scores. Results: We diagnosed and treated subluxation of the long head of the biceps easily using dynamic ultrasonography. At the final follow up, both patients' symptoms and functional outcomes were improved. There were no significant complications. Conclusion: Dynamic ultrasonography is a useful method in the difficult and subtle diagnosis of subluxation of the long head of the biceps.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2004.03a
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• pp.59-66
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• 2004

• Clinics in Shoulder and Elbow
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• v.9 no.1
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• pp.20-26
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• 2006

Purpose: To evaluate the usefulness and functional results of open repair of massive rotator cuff tears combined with or without the tenoplasty of biceps long head. Materials and Methods: From March 2003 to August 2004, we evaluated 18 cases of the patient treated with open repair of massive rotator cuff tears. The mean age was 56 years and mean follow-up period was 15 months. We performed open repair of massive rotator cuff tears by tendon to bone repair, but in irrepairable 4 cases for tendon to bone repair performed open repair combined with tenoplasty of biceps long head. The functional results were assessed using the Constant score, the parameters of which were pain, dialy activity, mobility, strength and satisfaction. Results: The functional results were excellent in 4 cases, good in 8 cases, fair in 3 cases and poor in 3 cases. And the results of open repair combined with tenoplasty of biceps long head were good in 2 cases and fair in 2 cases. Re-repair was done in 1 case for re-rupture. And the functional result of this case was fair. The 3 poor cases were suspected re-rupture, the factor of which old age and weakened rotator cuff. It was impossible to do re-repair. Conclusion: The open repair combined with or without tenoplasty of biceps long head is a useful and effective method for massive rotator cuff tear.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 1998.03a
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• pp.39-39
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• 1998

• Clinics in Shoulder and Elbow
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• v.21 no.4
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• pp.240-245
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• 2018

Rare cases of a congenital absence of the long head of the biceps tendon (LHBT) have been reported, and its incidence is unknown. In a literature review of the congenital absence of the LHBT, only 1 case was associated with posterior shoulder instability and severe posterior glenoid dysplasia. This paper reports the first case of a patient with a bilateral congenital absence of the LHBT with posterior shoulder instability without glenoid dysplasia or posterior glenoid tilt. The patient experienced a traffic accident while holding the gear stick with his right hand. After the accident, a posteroinferior labral tear with paralabral cysts was detected on the magnetic resonance images. The congenital absence of the LHBT was assumed to have affected the posterior instability that possibly increased the susceptibility to a subsequent traumatic posterior inferior labral tear. This case was identified as a posterior inferior tear caused by a traumatic 'gear stick injury'.

• Clinics in Shoulder and Elbow
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• v.16 no.2
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• pp.94-99
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• 2013

Purpose: The purpose of this study is to evaluate the clinical results of arthroscopic biceps long head suprapectoral tenodesis using an interference screw. Materials and Methods: We reviewed the cases of 30 patients who underwent arthroscopic biceps long head suprapectoral tenodesis using an interference screw between January 2008 and January 2010. The minimum follow up period was one year. Twenty patients had rotator cuff tears. The results were analyzed by VAS, ASES, tenderness in the bicipital groove, fixation failure, and the degree of deformity. Results: VAS, ASES scores showed a statistically significant increase during the final observation in all patients, compared with those before surgery. However, five patients (17%) had anterior shoulder pain and tenderness in the biceps groove, and three patients (10%) had Popeye deformity. Better results were achieved in patients without rotator cuff tear than in patients with rotator cuff tear (p<0.05). Conclusion: Arthroscopic biceps long head tenodesis above the pectoralis major using an interference screw in patients with a pathologic lesion of the proximal biceps tendon showed good results at the last follow up. However, further study for tenderness in the biceps groove in 17% of patients is needed.

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.7-13
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• 2010

Purpose: Our purpose was to retrospectively analyze clinical results of subpectoral tenodesis of the proximal biceps tendon using an interference screw. Materials and Methods: We reviewed 23 cases of patients receiving tenodesis of the proximal biceps tendon between January 2008 and January 2009 for whom we had follow-up data for at least 1 year. Twenty-three cases were operated on using subpectoral tenodesis; 16 of these cases had a rotator cuff tear. The results were judged using a visual analog scale (VAS), ASES, tenderness on the biceps groove, fixation failure and the degree of deformity (BAD). Results: VAS and ASES scores were significantly improved in all patients by the time of the final observation. There were no significant complications or fixation failures. The patients without a tear of the rotator cuff had a better result than patients with a tear of the rotator cuff, but the difference between the two groups was not significant (p>0.05). Conclusion: In patients with pathology of the long head of the biceps brachii, benefits of subpectoral interference screw tenodesis include pain relief, maintenance of functional biceps, muscle strength, and cosmesis. Subpectoral biceps tenodesis using interference screw fixation appears to be a promising, reproducible, reliable technique for addressing anterior shoulder pain related to pathology of the long head of the biceps brachii.