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Related Experiment Video

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An Investigation of the Effects of Sports-related Concussion in Youth Using Functional Magnetic Resonance Imaging and the Head Impact Telemetry System
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Popeye sign: Frequency and functional impact.

Laure Pouliquen1, Julien Berhouet2, Marion Istvan3

  • 1Service d'orthopédie, traumatologie, CHRU Pontchaillou, 35000 Rennes, France.

Orthopaedics & Traumatology, Surgery & Research : OTSR
|May 28, 2018
PubMed
Summary

The Popeye sign after long head of the biceps tenotomy during rotator cuff repair is uncommon and has minimal functional impact. This suggests tenotomy is a viable treatment option.

Keywords:
Long head of the bicepsPopeye signRotator cuffTenodesisTenotomy

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Shoulder Arthroscopy

Background:

  • The optimal surgical management for the long head of the biceps tendon during rotator cuff repair remains debated, with tenotomy and tenodesis as primary options.
  • The Popeye sign, a visible bulge resulting from tendon retraction, is often perceived as a negative outcome of tenotomy.

Purpose of the Study:

  • To investigate the incidence and clinical significance of the Popeye sign following tenotomy of the long head of the biceps tendon in patients undergoing rotator cuff repair.
  • To compare functional outcomes between patients who developed a Popeye sign and those who did not.

Main Methods:

  • A prospective, non-randomized study included 55 patients undergoing rotator cuff surgery with concomitant long head of the biceps tenotomy.
  • The presence of the Popeye sign was assessed 6 months postoperatively.
  • Patients were compared based on pain scores, range of motion, subjective shoulder value, discomfort, and Constant score.

Main Results:

  • The Popeye sign was observed in 15.2% (7 out of 55) of patients postoperatively.
  • No significant differences were found in pain, subjective shoulder value, or discomfort between groups.
  • Patients with the Popeye sign demonstrated a significantly greater improvement in the Constant score for range of motion (13.8 points vs. 3.8 points, p=0.01).

Conclusions:

  • The Popeye sign is infrequently observed after biceps tenotomy.
  • The functional impact of the Popeye sign appears minimal, with some evidence suggesting potential benefits in range of motion improvement.
  • Biceps tenotomy is a justifiable surgical choice for the long head of the biceps tendon in the context of rotator cuff repair.