The Experts below are selected from a list of 1695 Experts worldwide ranked by ideXlab platform
Jon J P Warner - One of the best experts on this subject based on the ideXlab platform.
-
the impact of workers compensation on recovery after biceps Tenodesis
Journal of Shoulder and Elbow Surgery, 2019Co-Authors: Eric R Wagner, Jarret M Woodmass, Michelle J Chang, Kathryn M Welp, Laurence D Higgins, Jon J P WarnerAbstract:Background There remains a paucity of studies examining the impact of workers' compensation (WC) on a variety of outcomes after biceps Tenodesis. The purpose of this study was to compare the postoperative recovery curves after biceps Tenodesis in patients with and without WC claims. Methods Using the Surgical Outcomes System database, we assessed the postoperative recovery outcomes of all patients who had outcomes recorded at least 6 months after isolated biceps Tenodesis for the treatment of a diagnosis of biceps tendinitis, stratified by WC status. The outcomes analyzed included visual analog scale, American Shoulder and Elbow Surgeons, VR-12 (Veterans RAND 12 Item Health Survey) mental and physical, Simple Shoulder Test, and Single Assessment Numeric Evaluation scores. Results Overall, 139 patients with WC claims underwent isolated biceps Tenodesis vs. 786 patients without WC claims. Demographic characteristics and comorbidities were similar in the 2 groups. Patients without WC claims had significantly improved visual analog scale, VR-12, American Shoulder and Elbow Surgeons, Single Assessment Numeric Evaluation, and Simple Shoulder Test scores at all times points after 3 months and 1 year compared with patients with WC claims. Conclusions On analysis of patients' recovery after isolated biceps Tenodesis, WC claims led to significantly worse pain and functional outcomes at every time point of analysis (3, 6, 12, and 24 months). Furthermore, patients with WC claims had worse preoperative-to-postoperative improvements in most outcomes. This information can be used to educate surgeons and patients on postoperative expectations, as well as to perform analyses focused on health economics, value, and policy.
-
surgical treatment of isolated type ii superior labrum anterior posterior slap lesions repair versus biceps Tenodesis
Journal of Shoulder and Elbow Surgery, 2014Co-Authors: Lewis L Shi, Jeffrey D Tompson, Michael T Freehill, Jon J P WarnerAbstract:Background It is still unclear which patients with isolated type II superior labrum anterior-posterior (SLAP) lesions benefit from either superior labral repair or biceps Tenodesis. This study evaluates the indications and outcomes of patients with isolated type II SLAP lesions who have undergone either procedure. Methods A retrospective analysis was performed of patients who had surgery for an isolated type II SLAP lesion between 2008 and 2011. There were 25 patients: 15 underwent biceps Tenodesis, with a mean follow-up of 31 months (range, 26-43 months), and 10 underwent SLAP repair, with a mean follow-up of 35 months (range, 25-52 months). The mean age was 47 years (range, 30-59 years) in the Tenodesis group and 31 years (range, 21-43 years) in the repair group. Results At latest follow-up, both groups showed significant improvements in subjective shoulder value and pain score. No difference was observed in American Shoulder and Elbow Surgeons score (93.0 vs 93.5, P = .45), patient satisfaction (93% vs 90%, P = .45), or return to preinjury sporting level (73% vs 60%, P = .66). Analysis of the indications for treatment showed that in the large majority, Tenodesis was performed in older patients (>35 years) and patients who showed degenerative or frayed labrums whereas SLAP repairs were performed in younger and more active patients with healthy-appearing labral tissue. There was only 1 failure in the Tenodesis group, and in the SLAP repair group, there were 2 cases of postoperative stiffness; all were treated nonoperatively. Conclusion In this study, we show that both biceps Tenodesis and SLAP repair can provide good to excellent results if performed in appropriately selected patients with isolated type II SLAP lesions.
-
clinical success of biceps Tenodesis with and without release of the transverse humeral ligament
Journal of Shoulder and Elbow Surgery, 2012Co-Authors: Brett Sanders, Kyle P Lavery, Scott D Pennington, Jon J P WarnerAbstract:Background Multiple methods for biceps Tenodesis exist, but long-term studies have demonstrated high failure rates. We hypothesized that Tenodesis techniques that do not release the biceps sheath are associated with a higher surgical revision rate than those that do. Methods A retrospective study was conducted of 127 biceps surgeries over a 2-year period. The mean follow-up post surgery was 22 months (range, 6-59). Clinical failure was defined as ongoing pain localized in the biceps groove, severe enough to warrant revision surgery. Results When all techniques that released the biceps sheath (6.8%, 4/59) were compared to those that did not release the biceps sheath (20.6%, 14/68), a statistically significant difference was found, P = .026 (chi-square). Proximal arthroscopic techniques were revised at a significantly higher rate than distal Tenodesis techniques ( P = .005). Conclusion Biceps Tenodesis techniques which do not release the biceps sheath or remove the tendon from the sheath have increased revision rates, compared to techniques that do. This may be supportive evidence for the theory that residual pain generating elements in the biceps groove is a cause of failure of proximal Tenodesis methods.
-
interference screw vs suture anchor fixation for open subpectoral biceps Tenodesis does it matter
BMC Musculoskeletal Disorders, 2008Co-Authors: Peter J Millett, Brett Sanders, Reuben Gobezie, Sepp Braun, Jon J P WarnerAbstract:Bioabsorbable interference screw fixation has superior biomechanical properties compared to suture anchor fixation for biceps Tenodesis. However, it is unknown whether fixation technique influences clinical results. We hypothesize that subpectoral interference screw fixation offers relevant clinical advantages over suture anchor fixation for biceps Tenodesis. Case Series. We performed a retrospective review of a consecutive series of 88 patients receiving open subpectoral biceps Tenodesis with either interference screw fixation (34 patients) or suture anchor fixation (54 patients). Average follow up was 13 months. Outcomes included Visual Analogue Pain Scale (0–10), ASES score, modified Constant score, pain at the Tenodesis site, failure of fixation, cosmesis, deformity (popeye) and complications. There were no failures of fixation in this study. All patients showed significant improvement between their preoperative and postoperative status with regard to pain, ASES score, and abbreviated modified Constant scores. When comparing IF screw versus anchor outcomes, there was no statistical significance difference for VAS (p = 0.4), ASES score (p = 0.2), and modified Constant score (P = 0.09). One patient (3%) treated with IF screw complained of persistent bicipital groove tenderness, versus four patients (7%) in the SA group (nonsignificant). Subpectoral biceps Tenodesis reliably relieves pain and improves function. There was no statistically significant difference in the outcomes studied between the two fixation techniques. Residual pain at the site of Tenodesis may be an issue when suture anchors are used in the subpectoral location.
Anthony A Romeo - One of the best experts on this subject based on the ideXlab platform.
-
the effect of concomitant biceps Tenodesis on reoperation rates after rotator cuff repair a review of a large private payer database from 2007 to 2014
Arthroscopy, 2017Co-Authors: Brandon J Erickson, Nikhil N Verma, Stephen J Obrien, Bryce A Basques, Justin W Griffin, Samuel A Taylor, Anthony A RomeoAbstract:Purpose To determine if reoperation rates are higher for patients who underwent isolated rotator cuff repair (RCR) than those who underwent RCR with concomitant biceps Tenodesis using a large private-payer database. Methods A national insurance database was queried for patients who underwent arthroscopic RCR between the years 2007 and 2014 (PearlDiver, Warsaw, IN). The Current Procedural Terminology (CPT) 29,827 (arthroscopy, shoulder, surgical; with RCR) identified RCR patients who were subdivided into 3 groups—group 1: RCR without biceps Tenodesis; group 2: RCR with concomitant arthroscopic biceps Tenodesis (CPT 29827 and 29,828); group 3: RCR with concomitant open biceps Tenodesis (CPT 29827 and 23,430). Reoperation rates (revision RCR, subsequent biceps surgeries) and complications at 30 days, 90 days, 6 months, and 1 year were analyzed. Multivariate logistic regression was used to compare reoperations and complications between groups. Rotator cuff tear size, whether the biceps was ruptured and whether a biceps tenotomy was performed, was not available. Results Group 1: 27,178 patients. Group 2: 4,810 patients. Group 3: 1,493 patients. More patients underwent concomitant arthroscopic than concomitant open Tenodesis ( P P Conclusions Higher reoperation rates at 1 year were seen in patients who had concomitant biceps Tenodesis. Level of Evidence Level III, case-control database review study.
-
biceps Tenodesis is a viable option for management of proximal biceps injuries in patients less than 25 years of age
Arthroscopy, 2017Co-Authors: Justin W Griffin, Bernard R. Bach, Timothy Leroux, Nikhil N Verma, Gregory L Cvetanovich, Jae Kim, Jonathan C Riboh, Brian J Cole, Gregory P Nicholson, Anthony A RomeoAbstract:Purpose To evaluate outcomes after biceps Tenodesis performed in patients younger than 25 years, to evaluate reoperations and complications in this population, and to critically appraise return to preinjury level of play for this population. Methods Forty-five consecutive patients younger than 25 years underwent subpectoral biceps Tenodesis for biceps tendinopathy or biceps-labral complex injuries including SLAP tears. Biceps Tenodesis was performed using an interference screw technique. Patients with a minimum 2-year follow-up were analyzed. Functional outcomes were assessed with the visual analog scale score, American Shoulder and Elbow Surgeons (ASES) score, ASES functional score, Simple Shoulder Test score, and range of motion. Activity level and return to sport were followed postoperatively. Results Of the 45 patients younger than 25 years who underwent biceps Tenodesis, 36 (80%) were available for follow-up at a minimum of 2 years, with a mean age of 19.8 years and mean follow-up period of 38.6 months. Of these 36 patients, 34 (94%) were athletes, with 20 patients playing at collegiate level. All clinical outcome scores improved, with the ASES score improving from 54.7 to 81.7, the ASES functional score improving from 17.5 to 25.1, and the Simple Shoulder Test score improving from 7.4 to 10.1 (P Conclusions When indicated, biceps Tenodesis offers an alternative to SLAP repair in young patients. Biceps Tenodesis in patients younger than 25 years yields satisfactory outcomes, with two-thirds of patients returning to sport and a low revision rate. Level of Evidence Level IV, therapeutic case series.
-
long head of the biceps tendinopathy diagnosis and management
Journal of The American Academy of Orthopaedic Surgeons, 2010Co-Authors: E Strauss, Augustus D. Mazzocca, Matthew T Provencher, Nikhil N Verma, Brett A Lenart, Anthony A RomeoAbstract:Tendinopathy of the long head of the biceps brachii encompasses a spectrum of pathology ranging from inflammatory tendinitis to degenerative tendinosis. Disorders of the long head of the biceps often occur in conjunction with other shoulder pathology. A thorough patient history, physical examination, and radiographic evaluation are necessary for diagnosis. Nonsurgical management, including rest, nonsteroidal anti-inflammatory drugs, physical therapy, and injections, is attempted first in patients with mild disease. Surgical management is indicated for refractory or severe disease. In addition to simple biceps tenotomy, a variety of Tenodesis techniques has been described. Open biceps Tenodesis has been used historically. However, promising results have recently been reported with arthroscopic Tenodesis.
-
clinical outcomes after subpectoral biceps Tenodesis with an interference screw
American Journal of Sports Medicine, 2008Co-Authors: Augustus D. Mazzocca, Anthony A Romeo, Mark P Cote, Cristina L Arciero, Robert A ArcieroAbstract:Background:Subpectoral biceps Tenodesis with an interference screw has been shown to be an effective procedure from both an anatomic and biomechanical perspective. There have been no clinical outcome data on this procedure to date.Hypothesis:Subpectoral biceps Tenodesis is an effective procedure in eliminating biceps tendinosis symptoms.Study Design:Case series; Level of evidence, 4.Methods:Patients who underwent subpectoral biceps Tenodesis with a minimum follow-up of 1 year were evaluated using a battery of clinical outcome measures, biceps apex difference, and pain scores. A diagnosis of biceps tendinosis was made using a specific diagnostic protocol coupled with observation of biceps tendon fraying and increased erythema on dry arthroscopy.Results:Between November 2002 and August 2005, 50 patients underwent subpectoral biceps Tenodesis. Complete follow-up examinations were performed in 41 of 50 (82%). There were 16 women and 25 men (mean age, 50 years). Follow-up averaged 29 months (range, 12–49 month...
-
subpectoral biceps Tenodesis
Sports Medicine and Arthroscopy Review, 2008Co-Authors: Matthew T Provencher, Lance E Leclere, Anthony A RomeoAbstract:Subpectoral biceps Tenodesis is a minimally invasive surgical technique that efficiently and reproducibly addresses long head of the biceps (LHB) tendon pathology. Indications for biceps Tenodesis include traumatic and degenerative tearing, biceps instability, rupture, and failed surgery. Subpectoral Tenodesis may be a preferred technique in the setting of complete LHB rupture, failed tenotomy, or prior Tenodesis. The LHB tendon is tenotomized arthroscopically at its origin, and a miniopen subpectoral approach is used to identify the tendon distally. Fixation is performed deep and just proximal to the inferior margin of the pectoralis major muscle. Fixation in this area can be achieved through the use of bone tunnels, an interference screw, suture anchor(s), or a cortical button. Attention is given to maintain the native position of the LHB musculotendinous junction relative to the inferior border of the pectoralis major. This technique maintains the biceps length–tension relationship and addresses intertubercular biceps pathology by eliminating pain generators within the bicipital groove. Superior biomechanical properties are achieved using interference screw fixation, and a single suture is added for reinforcement. Complications may occur in approximately 2% of patients and include infection, fixation failure, cosmetic deformity, cramping, fracture, and nerve injury.
Michael A Terry - One of the best experts on this subject based on the ideXlab platform.
-
all arthroscopic suprapectoral versus open subpectoral Tenodesis of the long head of the biceps brachii
American Journal of Sports Medicine, 2015Co-Authors: Mufaddal M Gombera, Cynthia A Kahlenberg, Rueben Nair, Matthew D Saltzman, Michael A TerryAbstract:Background:Pathologic changes of the long head of the biceps tendon are a recognized source of shoulder pain in adults that can be treated with tenotomy or Tenodesis when nonoperative measures are not effective. It is not clear whether arthroscopic or open biceps Tenodesis has a clinical advantage.Hypothesis:Pain relief and shoulder function after all-arthroscopic suprapectoral biceps Tenodesis are similar to outcomes after an open subpectoral Tenodesis.Study Design:Cohort study; Level of evidence, 3.Methods:A prospective database was reviewed for patients undergoing an all-arthroscopic suprapectoral or open subpectoral biceps Tenodesis. Adult patients with a minimum 18-month follow-up were included. Patients undergoing a concomitant rotator cuff or labral repair were excluded. The groups were matched to age within 3 years, sex, and time to follow-up within 3 months. Pain improvement, development of a “Popeye” deformity, muscle cramping, postoperative American Shoulder and Elbow Surgeons scores, satisfact...
Ganesh V Kamath - One of the best experts on this subject based on the ideXlab platform.
-
surgical trends in the treatment of superior labrum anterior and posterior slap lesions of the shoulder analysis of data from the american board of orthopaedic surgery certification examination database
Orthopaedic Journal of Sports Medicine, 2014Co-Authors: Brendan Mackinnonpatterson, Jeffrey T Spang, Robert A Creighton, Ganesh V KamathAbstract:Background:After failure of nonoperative treatment, repair has long been the primary treatment option for symptomatic superior labrum anterior and posterior (SLAP) lesions of the shoulder. There is growing evidence to support both biceps tenotomy and Tenodesis as effective alternative treatments for SLAP lesions.Hypotheses:For patients with isolated SLAP lesions, the frequency of SLAP repair has decreased, while treatment with biceps Tenodesis and tenotomy has increased. Similar trends are expected in patients with SLAP lesions undergoing concomitant rotator cuff repair.Study Design:Cohort study; Level of evidence, 3.Methods:A query of the American Board of Orthopaedic Surgery part II database was performed from 2002 to 2011. The database was searched for patients with isolated SLAP lesions undergoing SLAP repair, open biceps Tenodesis, arthroscopic biceps Tenodesis, or biceps tenotomy. The database was then queried a second time for patients undergoing arthroscopic rotator cuff repair with concomitant SL...
-
surgical trends in the treatment of superior labrum anterior and posterior lesions of the shoulder
American Journal of Sports Medicine, 2014Co-Authors: Brendan M Patterson, Alexander R Creighton, Jeffrey T Spang, James R Roberson, Ganesh V KamathAbstract:Background:After failure of nonoperative treatment, repair has long been the primary treatment option for symptomatic superior labrum anterior and posterior (SLAP) lesions of the shoulder. There is growing evidence to support both biceps tenotomy and Tenodesis as effective alternative treatments for SLAP lesions.Hypotheses:For patients with isolated SLAP lesions, the frequency of SLAP repair has decreased, while treatment with biceps Tenodesis and tenotomy has increased. Similar trends are expected in patients with SLAP lesions undergoing concomitant rotator cuff repair.Study Design:Cohort study; Level of evidence, 3.Methods:A query of the American Board of Orthopaedic Surgery part II database was performed from 2002 to 2011. The database was searched for patients with isolated SLAP lesions undergoing SLAP repair, open biceps Tenodesis, arthroscopic biceps Tenodesis, or biceps tenotomy. The database was then queried a second time for patients undergoing arthroscopic rotator cuff repair with concomitant SL...
-
surgical trends in the treatment of superior labrum anterior and posterior lesions of the shoulder analysis of data from the american board of orthopaedic surgery certification examination database
American Journal of Sports Medicine, 2014Co-Authors: Brendan M Patterson, Alexander R Creighton, Jeffrey T Spang, James R Roberson, Ganesh V KamathAbstract:Background:After failure of nonoperative treatment, repair has long been the primary treatment option for symptomatic superior labrum anterior and posterior (SLAP) lesions of the shoulder. There is growing evidence to support both biceps tenotomy and Tenodesis as effective alternative treatments for SLAP lesions.Hypotheses:For patients with isolated SLAP lesions, the frequency of SLAP repair has decreased, while treatment with biceps Tenodesis and tenotomy has increased. Similar trends are expected in patients with SLAP lesions undergoing concomitant rotator cuff repair.Study Design:Cohort study; Level of evidence, 3.Methods:A query of the American Board of Orthopaedic Surgery part II database was performed from 2002 to 2011. The database was searched for patients with isolated SLAP lesions undergoing SLAP repair, open biceps Tenodesis, arthroscopic biceps Tenodesis, or biceps tenotomy. The database was then queried a second time for patients undergoing arthroscopic rotator cuff repair with concomitant SL...
Jens Ivar Brox - One of the best experts on this subject based on the ideXlab platform.
-
sham surgery versus labral repair or biceps Tenodesis for type ii slap lesions of the shoulder a three armed randomised clinical trial
British Journal of Sports Medicine, 2017Co-Authors: Cecilie Piene Schroder, Oystein Skare, Olav Reikeras, Petter Mowinckel, Jens Ivar BroxAbstract:Background Labral repair and biceps Tenodesis are routine operations for superior labrum anterior posterior (SLAP) lesion of the shoulder, but evidence of their efficacy is lacking. We evaluated the effect of labral repair, biceps Tenodesis and sham surgery on SLAP lesions. Methods A double-blind, sham-controlled trial was conducted with 118 surgical candidates (mean age 40 years), with patient history, clinical symptoms and MRI arthrography indicating an isolated type II SLAP lesion. Patients were randomly assigned to either labral repair (n=40), biceps Tenodesis (n=39) or sham surgery (n=39) if arthroscopy revealed an isolated SLAP II lesion. Primary outcomes at 6 and 24 months were clinical Rowe score ranging from 0 to 100 (best possible) and Western Ontario Shoulder Instability Index (WOSI) ranging from 0 (best possible) to 2100. Secondary outcomes were Oxford Instability Shoulder Score, change in main symptoms, EuroQol (EQ-5D and EQ-VAS), patient satisfaction and complications. Results There were no significant between-group differences at any follow-up in any outcome. Between-group differences in Rowe scores at 2 years were: biceps Tenodesis versus labral repair: 1.0 (95% CI −5.4 to 7.4), p=0.76; biceps Tenodesis versus sham surgery: 1.6 (95% CI −5.0 to 8.1), p=0.64; and labral repair versus sham surgery: 0.6 (95% CI −5.9 to 7.0), p=0.86. Similar results—no differences between groups—were found for WOSI scores. Postoperative stiffness occurred in five patients after labral repair and in four patients after Tenodesis. Conclusion Neither labral repair nor biceps Tenodesis had any significant clinical benefit over sham surgery for patients with SLAP II lesions in the population studied. Trial registration number ClinicalTrials.gov identifier: NCT00586742
