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Proximal Biceps, An Issue of Clinics in Sports Medicine, E-Book

Proximal Biceps, An Issue of Clinics in Sports Medicine, E-Book

Anthony A Romeo

(2016)

Additional Information

Book Details

Abstract

This issue will focus on the management and treatment Proximal Biceps, including articles on the following: Anatomy and Biomechanics of the proximal biceps tendon, Physical Examination of proximal biceps disorders, Imaging for proximal biceps disorders, Nonoperative management of proximal biceps disorders (including USG guided injections technique), Tenotomy versus tenodesis, Injuries to the Bicep Pulley, and many more!

Table of Contents

Section Title Page Action Price
Front Cover Cover
Proximal Biceps\r i
Copyright\r ii
Contributors iii
CONSULTING EDITOR iii
EDITOR iii
AUTHORS iii
Contents vii
Foreword\r vii
Preface: The Proximal Biceps Tendon\r vii
Clinically Relevant Anatomy and Biomechanics of the Proximal Biceps\r vii
Injuries to the Biceps Pulley\r vii
Examination of the Biceps Tendon\r vii
How Accurate Are We in Detecting Biceps Tendinopathy?\r viii
Nonoperative Management (Including Ultrasound-Guided Injections) of Proximal Biceps Disorders\r viii
The Painful Long Head of the Biceps Brachii: Nonoperative Treatment Approaches\r viii
Biceps Tenotomy Versus Tenodesis\r viii
Arthroscopic Surgical Techniques for the Management of Proximal Biceps Injuries\r ix
Open Subpectoral Tenodesis of the Proximal Biceps\r ix
Proximal Biceps Tendon and Rotator Cuff Tears\r ix
Proximal Biceps in Overhead Athletes\r ix
Complications of Proximal Biceps Tenotomy and Tenodesis\r x
CLINICS IN SPORTS MEDICINE\r xi
FORTHCOMING ISSUES xi
April 2016 xi
July 2016 xi
October 2016 xi
RECENT ISSUES xi
October 2015 xi
July 2015 xi
April 2015 xi
January 2015 xi
Foreword: The Proximal Biceps Tendon \r xiii
Preface: The Proximal Biceps Tendon \r xv
Clinically Relevant Anatomy and Biomechanics of the Proximal Biceps 1
Key points 1
INTRODUCTION 1
ANATOMY AND FUNCTION 2
Inside 2
Glenoid labrum 2
Superior labrum 2
Biceps anchor 3
Junction 4
Intra-articular long head of the biceps tendon 4
Biceps pulley 4
Injuries to the Biceps Pulley 19
Key points 19
INTRODUCTION 19
CLASSIFICATION 20
CLINICAL EXAMINATION 20
IMAGING 21
INDICATIONS FOR OPERATIVE TREATMENT 22
SURGICAL OPTIONS 22
Preparation and Patient Positioning 23
Diagnostic Arthroscopy 23
THE AUTHORS’ PREFERRED TECHNIQUE FOR TREATMENT OF BICEPS PULLEY LESIONS 23
COMPLICATIONS AND MANAGEMENT 24
POSTOPERATIVE CARE 24
OUTCOMES 25
SUMMARY 26
REFERENCES 26
Examination of the Biceps Tendon 29
Key points 29
INTRODUCTION 29
EXAMINATION BASICS 31
OBSERVATION 32
The Ludington Test 32
Biceps Tenderness 32
BICEPS INSTABILITY TESTS 34
Yergason’s Test 35
Speed’s Test 36
Lift-off Test 36
Biceps Entrapment Test 37
SUPERIOR LABRUM ANTERIOR AND POSTERIOR LESIONS 38
Dynamic Shear Test 38
Active Compression Test 40
Multiple Physical Examination Tests for Superior Labrum Anterior and Posterior Lesions 41
SUMMARY 42
REFERENCES 42
How Accurate Are We in Detecting Biceps Tendinopathy? 47
Key points 47
INTRODUCTION: NATURE OF THE PROBLEM 47
INDICATIONS FOR IMAGING OF THE BICEPS 47
What Do We Know About Biceps Tendinopathy? 47
Indications for Imaging 51
STUDIES EVALUATING THE EFFICACY OF MRI 51
Studies Considering the Speed and Yergason Tests 53
DISCUSSION 53
SUMMARY 54
REFERENCES 54
Nonoperative Management (Including Ultrasound-Guided Injections) of Proximal Biceps Disorders 57
Key points 57
LONG HEAD OF BICEPS TENDON 57
Anatomy 58
Pathologic Conditions 58
PATIENT EVALUATION 58
Clinical Presentation/Physical Examination 58
Differential Diagnosis 60
MUSCULOSKELETAL ULTRASOUND EVALUATION AND INTERVENTION 60
Overview 60
Long Head of Biceps Tendon Ultrasound Protocol/Clinical Case 62
Ultrasound-Guided Injection/Clinical Case 62
Additional Advanced Imaging 63
NONOPERATIVE ALGORITHM 63
Overview 63
Nonsteroidal Anti-inflammatory Drugs, Corticosteroid Injections, and Other Modalities 65
Regenerative Injection Therapy for Long Head of Biceps Tendon Disorders 67
Multiphase physical rehabilitation 69
Treatment follow-up 69
Referral for surgical evaluation 69
SUMMARY 70
REFERENCES 71
The Painful Long Head of the Biceps Brachii 75
Key points 75
FUNCTION 76
Classification of Long Head of the Biceps Pain and Pathophysiology 76
Traumatic injuries 76
Instability 77
Biceps Tendinopathy 77
Biomechanical Dysfunction 78
Capsular Involvement 78
Superior Labral Anterior Posterior Lesions 78
CLINICAL EXAMINATION 78
History 79
NONOPERATIVE TREATMENT 79
PHASE 1: ACUTE PHASE 80
PHASE 2: INTERMEDIATE PHASE 83
PHASE 3: ADVANCED STRENGTHENING PHASE 84
PHASE 4: RETURN TO ACTIVITY PHASE 86
SUMMARY 86
REFERENCES 86
Biceps Tenotomy Versus Tenodesis 93
Key points 93
INTRODUCTION 93
PATHOLOGIC ENTITIES 94
PREOPERATIVE MANAGEMENT 94
PHYSICAL EXAMINATION 95
PREOPERATIVE PLANNING 95
TENODESIS VERSUS TENOTOMY 97
ARTHROSCOPIC EVALUATION OF THE LONG HEAD BICEPS TENDON 98
SURGICAL OPTIONS 99
SURGICAL TECHNIQUES 99
Arthroscopic Biceps Tenotomy 99
Arthroscopic Looped Tenotomy 99
Tenodesis 100
Mini-Open Subpectoral Biceps Tenodesis 101
RESULTS AND CLINICAL OUTCOMES 103
COSMETIC DEFORMITY 103
SUBJECTIVE OUTCOMES 105
RESIDUAL POSTOPERATIVE BICIPITAL SHOULDER PAIN 106
OBJECTIVE OUTCOMES 107
REVISION RATES 107
COMPLICATIONS 107
BIOMECHANICAL EVALUATION 108
POSTOPERATIVE REHABILITATION PROTOCOL 108
SUMMARY 108
REFERENCES 109
Arthroscopic Surgical Techniques for the Management of Proximal Biceps Injuries 113
Key points 113
ARTHROSCOPIC SUPERIOR LABRUM ANTERIOR TO POSTERIOR REPAIR 114
Introduction 114
Indications/Contraindications 114
Surgical Technique 115
Postoperative Care 117
Outcomes 118
ARTHROSCOPIC PROXIMAL BICEPS TENODESIS 118
Introduction 118
Indications/Contraindications 118
Surgical Technique 125
Complications and Management 130
Postoperative Care 130
Outcomes 130
SUMMARY 130
REFERENCES 131
Open Subpectoral Tenodesis of the Proximal Biceps 137
Key points 137
INTRODUCTION 137
INDICATIONS/CONTRAINDICATIONS 138
SURGICAL TECHNIQUES 138
Bone Tunnel Technique 138
Cortical Button Technique 139
Keyhole Technique 140
Suture Anchor Technique 140
Interference Screw Technique 140
PREPARATION AND PATIENT POSITIONING 140
SURGICAL APPROACH 141
BIOMECHANICS 144
COMPLICATIONS AND MANAGEMENT 149
POSTOPERATIVE CARE 149
CLINICAL OUTCOMES 149
REFERENCES 150
Proximal Biceps Tendon and Rotator Cuff Tears 153
Key points 153
INTRODUCTION 153
PROXIMAL BICEPS AND ROTATOR CUFF TEARS 154
Disorders 154
SPONTANEOUS RUPTURE OF THE LONG HEAD OF THE BICEPS TENDON 154
MECHANICAL ENTRAPMENT OF THE DISEASED LONG HEAD OF THE BICEPS TENDON 155
INSTABILITY OF THE LONG HEAD OF THE BICEPS TENDON 155
DIAGNOSIS AND IMAGING 156
TREATMENT 156
SUMMARY 159
REFERENCES 159
Proximal Biceps in Overhead Athletes 163
Key points 163
INTRODUCTION 163
OVERVIEW OF PATIENT EVALUATION 166
Physical Examination Maneuvers 166
Diagnostic Imaging 167
PHARMACOLOGIC TREATMENT OPTIONS 168
NONPHARMACOLOGIC TREATMENT OPTIONS 169
SURGICAL TREATMENT OPTIONS 170
Glenohumeral Function of the Tendon of the Long Head of the Biceps 170
Arthroscopic Assessment 170
Operative Technique for Repair of Superior Labral Anterior-Posterior Tears 171
Open Subpectoral Biceps Tenodesis 171
TREATMENT COMPLICATIONS 172
EVALUATION OF OUTCOMES 172
Nonoperative Treatment 172
Superior Labral Anterior-Posterior Repair 173
Biceps Tenodesis 173
Comparative Studies 173
SUMMARY 174
REFERENCES 174
Complications of Proximal Biceps Tenotomy and Tenodesis 181
Key points 181
INTRODUCTION 181
COMPLICATIONS OF BICEPS TENOTOMY 182
COMPLICATIONS OF BICEPS TENODESIS 183
SUMMARY 186
REFERENCES 186
Index 189