Rotator Cuff Tear. Partial Repair with Long Head Biceps Augmentation Volume 55- Issue 2

Rebeca Garcia Barcenilla^1* and Ciro Santos Ledo²

• ¹Valdecilla University Hospital, Santander - Cantabria, Spain
• ²Sierrallana Hospital. Torrelavega- Cantabria. Spain

Received: February 16, 2024; Published: February 27, 2024

*Corresponding author: Rebeca Garcia Barcenilla, Valdecilla University Hospital, Santander-Cantabria, Spain

DOI: 10.26717/BJSTR.2024.55.008682

Abstract PDF

Surgical treatment of retracted rotator cuff tears is a big deal. The healing outcomes are usually bad.

show our technique to repair a rotator cuff tear and how we perform an augmentation with the long head biceps (LHB).

Clinical case: 58 years old woman with a long history of right shoulder pain. Physical exam: active flexion 120º, normal internal and external rotations Jobe sign positive, bear hug negative. MRI: total supraspinatus (SE) tear with grade 3 retraction and grade 3 fat atrophy (Figure 1) [1,2].

Figure 1

Under general anesthesia and additional interscalene nerve block, the patient is placed in the lateral position. Right shoulder arthroscopy through as usual portals is performed. The subscapularis tendon was conserved and the LHB did not have any tendinopathy signs. The SE tendon had a total tear retracted until the glenoid and it was only amenable to be reduced to the half posterior area of the footprint. A 4,5mm Cross Ft (Linvatec) was used to move the LHB from the bicipital groove to the center of the humeral head. Two sutures were passed through the LHB, performing a “lasso-loop” configuration. The suture stumps rested in another portal to use them later. After that, the infraspinatus and SE tendon were repaired with a 4,5mm Cross Ft (Linvatec) posterior in the footprint, using a combination of mattress and Mason Allen suture techniques. Finally, we passed the sutures used in the LHB through the supraspinatus tendon to enhance the repair, to avoid tendon retraction and to cover the maximum area possible. providing an additional side-to-side, “tension-free” marginal repair of the SE tendon with the LHBT (Figures 2-5).

Figure 2

Figure 3

Figure 4

Figure 5

Patient wore a sling for 6 weeks. She attended physiotherapy treatment. 9 months after surgery she didn’t feel any pain, had returned to her previous work and her mobility was complete.

Figure 6

We need more reports to know the real effectiveness of this technique. At the moment, it is an economic alternative with less resources needed.

1. Achilleas Boutsiadis, Shiyi Chen, P Chunyan Jiang,Hubert Lenoir, Philippe Delsol,et al. (2017) Long Head of the Biceps as a Suitable Available Local. Tissue Autograft for Superior Capsular Reconstruction: “The Chinese Way”. Arthrosc Tech 6(5): e1559-e1566.
2. Kashif A Memon, Richard A C Dimock, Timothy Cobb, Paolo Consigliere, Mohamed A Imam, et al. (2020) Hamburger Technique: Augmented Rotator Cuff Repair With Biological Superior Capsular Reconstruction. Arthrosc Tech 9(7): e987-e993.