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Biceps tendon and superior labral injuries.

J D Grauer1, L E Paulos, W P Smutz

  • 1Orthopedic Professional Association, P.C., Louisville, Colorado 80027.

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association
|January 1, 1992
PubMed
Summary

Injuries to the biceps tendon and superior labrum can occur together. Arthroscopic findings and patient anatomy help diagnose and treat these complex shoulder injuries.

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Anatomy

Background:

  • Injuries to the biceps tendon, rotator cuff interval, and superior labrum are common in the shoulder.
  • These injuries can present complex diagnostic challenges, often requiring arthroscopic evaluation.
  • Understanding the anatomical relationship between the biceps tendon and superior labrum is crucial for effective treatment.

Purpose of the Study:

  • To investigate the spectrum of injuries involving the biceps tendon and superior labrum.
  • To correlate arthroscopic findings with clinical outcomes.
  • To analyze the biomechanics of labral and biceps tendon strain during simulated muscle contraction.

Main Methods:

  • Retrospective review of 22 patients with biceps tendon, rotator cuff interval, or superior labrum injuries.

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  • Surgical interventions included biceps tenodesis, biceps repair, subscapularis repair, and labral debridement.
  • Cadaveric shoulder dissection and biomechanical testing of labral and tendon strain during simulated biceps contraction.

    • Main Results:

    • Seven patients with interval lesions underwent tenodesis (n=7), repair (n=1), or subscapularis repair (n=3), with high satisfaction despite one tenodesis failure.
    • Thirteen patients with superior labrum anterior to posterior (S.L.A.P.) lesions treated with debridement achieved pain relief in all but one case.
    • Arthroscopic findings frequently included biceps or subscapularis fraying; biomechanical studies demonstrated significant labral strain in abduction and biceps strain in adduction.

    Conclusions:

    • A continuum of injuries exists from the rotator cuff interval to the superior labrum, involving the biceps tendon.
    • Key arthroscopic findings can aid in diagnosing challenging interval lesions.
    • Individual patient anatomy and injury mechanism likely dictate the specific site of injury.