The Hitchcock procedure. A cause for failure: a case report

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder Arthroscopy

Background:

• Biceps tendinitis is a common cause of shoulder pain.
• The Hitchcock procedure (tenodesis of the long head of the biceps) is used to treat this condition.
• Recurrence of pain after surgery can occur.

Observation:

• A patient experienced recurrent shoulder pain seven months post-Hitchcock operation.
• X-rays revealed upward humeral head migration and decreased acromiohumeral interval during biceps contraction.
• This suggests altered shoulder biomechanics after the procedure.

Findings:

• Resection of the intra-articular biceps segment may destabilize the humeral head.
• The short head of the biceps may then cause proximal migration of the humeral head.
• This can lead to impingement and pain recurrence.

Implications:

• The Hitchcock procedure may have suboptimal long-term outcomes due to biomechanical changes.
• Alternative surgical techniques may be necessary for persistent biceps tendinitis.
• Further research is needed to understand the long-term effects of biceps tenodesis.