Portal de Periódicos da CAPES

31

2007; Elsevier BV; Volume: 16; Issue: 2 Linguagem: Inglês

10.1016/j.jse.2007.02.080

1532-6500

Richard J. Hawkins, John R. Shank, Michael J. Kissenberth, Arun Ramapa, Steven B. Singleton, Michael R. Torry, Michael J. Decker,

Background: Multiple studies support both tenotomy and tenodesis of the long head of the biceps tendon (LHBT) as a surgical treatment option for painful proximal LHBT pathology. Some favor tenodesis over tenotomy as tenotomy has been theorized to lead to increased postoperative weakness. However, there is no current strength analysis study comparing LHBT tenotomy to tenodesis. The purpose of the present study was to compare the forearm supination and elbow flexion strength of the upper extremity in patients who have had an arthroscopic LHBT release with patients that have had an LHBT tenodesis. Hypothesis: The experimental hypothesis is that forearm supination and elbow flexion strength will be less in the biceps tenotomy group compared to the biceps tenodesis group. Study Design: Case Control Study; level III. Methods: Cybex isokinetic strength testing was performed on 17 patients who underwent arthroscopic LHBT tenotomy, 19 patients who underwent arthroscopic LHBT tenodesis and 31 age, gender and BMI matched control subjects. Subjects were considered fully recovered from shoulder surgery, were released for unrestricted activities, and were at least 6 months post-operation prior to testing. Subjects were tested for forearm supination and elbow flexion strength of both arms using a Cybex II NORM isokinetic dynamometer at 60 and 120 degrees per second. Testing was performed on injured and uninjured arms as well as dominant and nondominant arms in controls. Both forearm supination and elbow flexion strength values were recorded. Results: Comparison between involved and uninvolved upper extremities within each group utilizing a paired t-test showed a 7% increase in elbow flexion strength when comparing dominant and non-dominant arms at 60 deg/sec. Comparison between groups utilizing 2×3 ANOVA (speed x group) showed no statistical difference in either forearm supination or elbow flexion strength comparing the tenotomy, tenodesis, and control groups. Conclusion: Both LHBT tenotomy and tenodesis are valuable surgical options in the treatment of the symptomatic LHBT. Following either procedure, no statistically significant forearm supination or elbow flexion strength differences existed in the involved extremity between the two study groups. If noted, the author indicates something of value received. The codes are identified as follows: a, research or institutional support; b, miscellaneous funding; c, royalties; d, stock options; e, consultant or employee. *The Food and Drug Administration has not cleared the drug and/or medical device for the use described in this presentation (ie, the drug or medical device is being discussed for an “off-label” use). If noted, the author indicates something of value received. The codes are identified as follows: a, research or institutional support; b, miscellaneous funding; c, royalties; d, stock options; e, consultant or employee. *The Food and Drug Administration has not cleared the drug and/or medical device for the use described in this presentation (ie, the drug or medical device is being discussed for an “off-label” use). If noted, the author indicates something of value received. The codes are identified as follows: a, research or institutional support; b, miscellaneous funding; c, royalties; d, stock options; e, consultant or employee. *The Food and Drug Administration has not cleared the drug and/or medical device for the use described in this presentation (ie, the drug or medical device is being discussed for an “off-label” use).