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• W1991495846 abstract "Le but de ce travail était d’évaluer les résultats cliniques et radiologiques à moyen terme des ténotomies arthroscopiques du chef long du biceps brachial dans le traitement des ruptures jugées irréparables de la coiffe des rotateurs. La série se composait de 40 épaules opérées d’une ténotomie isolée dans 32 cas et associée à une acromioplastie dans 8 cas. Le recul moyen était de 30 mois. La rupture de la coiffe intéressait le seul supra-épineux dans 11 cas, le supra-épineux et l’infra-épineux dans 12 cas, le supra-épineux et le subscapularis dans 9 cas et les trois tendons dans 8 cas. À la révision, le score de Constant brut moyen était de 58 points soit un gain de 20 points. Le gain concernait la douleur (+ 7,1 points), le niveau d’activité (+ 6,6 points) et la mobilité (+6,4 points). Seule la force musculaire en flexion-supination du coude était diminuée par l’intervention puisque les mesures réalisées sur les patients opérés révélaient une diminution de 40 % comparativement à une série témoin appariée à l’âge, au sexe et en tenant compte de la dominance du membre. L’analyse radiographique au recul ne révélait pas de tendance générale à l’excentration supérieure de la tête humérale ou au développement d’une omarthrose secondaire. Toutefois, 2 patients, au recul de 41 et de 72 mois, avaient développé une arthose excentrée. Les résultats à moyen terme de la ténotomie arthroscopique du chef long du biceps brachial sont satisfaisants au prix d’un geste techniquement simple aux conséquences fonctionnelles limitées. Toutefois, la dégradation du résultat chez une patiente au recul de 6 ans doit nous rendre prudent sur le bénéfice à long terme de cette intervention. Appropriate treatment of irreparable rotator cuff tears in patients without osteoarthritic shoulder joints remains a subject of debate. Medical treatment, a substitution muscle flap, and palliative arthroscopic treatment have been proposed. Arthroscopic tenotomy of the long head of the biceps brachii is warranted because this tendon is often the cause of part or all of the pain. If there is a full thickness tear of the rotator cuff, the exposed tendon of the long head of the biceps brachii can, because of its anterosuperior position, become impinged against the acromial vault during forward flexion. The purpose of this work was to evaluate the mid-term clinical and radiological results of arthroscopic tenotomy of the long head of the biceps brachii during treatment of full thickness tears of the rotator cuff. The series included 40 shoulders operated on for tenotomy alone (n = 32) or in combination with acromioplasty (n = 8). The long head of the biceps brachii was in place in 23 shoulders (58%), displaced in seven and subluxed in five. The position was not determined in five. At last follow-up, the mean rough Constant score was 58 points, giving a gain of 20 points. The gain for pain was +7.1 points, +6.4 points for activity, and +6.6 points for motion. After the operation, muscle force for elbow flexion-supination was decreased 40% compared with an age-, sex- and dominance-matched control group. 86% of the patients were satisfied with the outcome and only two patients were disappointed by the asymmetry of arm muscle volume. Radiographically, at last follow-up there were no signs of superior excentration of the humeral head and the subacromial space, which measured 7.38 mm preoperatively was 7.19 mm postoperatively. Likewise only two shoulders progressed to excentered osteoarthritis at 41and 72 months. Mid-term results of arthroscopic tenotomy of the long head of the biceps brachii are satisfactory. The technique is simple and has limited functional consequences. The procedure has an undeniable impact on pain and has allowed a 34° gain in anterior flexion of the shoulder. Complementary acromioplasty was not found to provide a supplementary benefit in this series. Nevertheless, the degradation of the result in one female patient at six years suggests we should be prudent concerning the long-term benefit of this procedure which should be reserved for irreparable tears in patients with minimal functional demands." @default.
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• W1991495846 date "2005-06-01" @default.
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• W1991495846 title "Résultats de la ténotomie arthroscopique du chef long du biceps brachial dans les ruptures transfixiantes de la coiffe des rotateurs non réparées" @default.
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• W1991495846 doi "https://doi.org/10.1016/s0035-1040(05)84327-2" @default.
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