Progression of degenerative changes of the biceps tendon after successful rotator cuff repair

• Published in: Journal of shoulder and elbow surgery Vol. 26; no. 3; pp. 424 - 429
• Main Authors: Takahashi, Norimasa, MD, Sugaya, Hiroyuki, MD, Matsumoto, Momoko, RT, Miyauchi, Hikaru, RT, Matsuki, Keisuke, MD, Tokai, Morihito, MD, Kawai, Nobuaki, MD, Onishi, Kazutomo, Ueda, Yusuke, MD, Hoshika, Shota, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2017
• Subjects: anterior shoulder pain; arthroscopic rotator cuff repair; Arthroscopy; biceps hypertrophy; Disease Progression; Female; Follow-Up Studies; Humans; Long head of the biceps; Male; Middle Aged; Orthopedics; Pain Measurement; power Doppler sonography; Prognosis; Rotator Cuff Injuries - surgery; Shoulder - diagnostic imaging; Shoulder Pain - etiology; Tendons - blood supply; Tendons - diagnostic imaging; Tendons - surgery; Ultrasonography, Doppler; ultrasound; Wound Healing; anterior shoulder pain; Level II; power Doppler sonography; biceps hypertrophy; arthroscopic rotator cuff repair; Long head of the biceps; ultrasound; Prognosis Study
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2016.09.052

Background This study investigated the morphologic changes in the biceps tendon using ultrasonography before and after successful arthroscopic posterosuperior rotator cuff repair. Methods Forty-four patients (44 shoulders) underwent arthroscopic posterosuperior rotator cuff repair with 1-year postoperative magnetic resonance imaging (MRI) follow-up. The patients comprised 22 men and 22 women with an average age of 61 years. The cross-sectional area (CSA) of the biceps tendon in the bicipital groove was measured, and the vascularity in the bicipital groove was graded as 0 to 3, based on the signal density of the anterior circumflex artery, using power Doppler ultrasonography. The preoperative and postoperative CSA and vascularity grades were compared. The pain score on the University of California, Los Angeles Shoulder Rating Scale was used to analyze the correlation between vascularity and postoperative pain. Results The average preoperative and postoperative CSA of the biceps tendon was 15.4 ± 6.5 and 17.9 ± 7.5 mm2 , respectively. The postoperative CSA was significantly larger than the preoperative CSA ( P  < .01). Although no significant difference in the vascularity of the bicipital groove was observed between preoperative and postoperative grading, a negative correlation was observed between the vascularity and postoperative pain score on the University of California, Los Angeles scale ( r  = −0.369). Conclusions The biceps tendon in the bicipital groove becomes thicker over time, even after successful posterosuperior rotator cuff repair. In addition, an increase in the vascularity around the biceps tendon in the groove is correlated with pain symptoms after successful repair.