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Related Concept Videos

Muscles of the Shoulder01:23

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The muscles surrounding the shoulder girdle, including the clavicle and scapula, primarily stabilize the scapula. This stable base allows other muscles to move the humerus effectively. Scapular movements often mirror those of the humerus and extend its range of motion. For instance, raising the arm above the head would not be feasible without simultaneous upward rotation of the scapula.
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Nine muscles are involved in arm movements. Two of these, the pectoralis major and latissimus dorsi, originate from the axial skeleton and are called axial muscles. The other seven originate from the scapula and are called the scapular muscles.
The pectoralis major has two origins. Its clavicular head originates on the medial half of the clavicle. In contrast, the sternocostal head originates on the costal cartilages of ribs 1-6, the sternum, and the aponeurosis of the external oblique of the...
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Reverse Total Shoulder Arthroplasty
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Pulley ring suture increases shoulder stability after biceps tendon transposition.

Duzheng Zhang1, Jiezhou Wu1, Liyun Zhang2

  • 1Department of Orthopaedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.

Frontiers in Surgery
|March 11, 2025
PubMed
Summary

Modified double-row biceps tenodesis (MDBT) with pulley ring repair improves long-term shoulder function and stability. This technique enhances glenohumeral joint restoration compared to traditional MDBT for SLAP lesions.

Keywords:
Pulley ringSLAP lesionsmodified double-row biceps tenodesisshoulder arthroscopysuperior labrum anterior and posterior lesions

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Shoulder Reconstruction

Background:

  • Superior Labrum Anterior to Posterior (SLAP) lesions are common shoulder injuries.
  • Modified double-row biceps tenodesis (MDBT) is an effective treatment for SLAP injuries.
  • The role of concomitant pulley ring repair in MDBT outcomes requires further investigation.

Purpose of the Study:

  • To evaluate the long-term impact of pulley ring repair during MDBT on shoulder function and stability.
  • To compare outcomes between MDBT with and without pulley ring repair in patients with type II SLAP lesions.

Main Methods:

  • Retrospective study of 157 patients with isolated unilateral type II SLAP lesions treated with MDBT.
  • Patients were divided into two groups: without pulley ring repair (n=77) and with pulley ring repair (n=80).
  • Statistical analyses (t-test, Anova, chi-square) and Lasso regression were used to identify significant variables and construct a predictive model.

Main Results:

  • Significant differences in ASES and UCLA scores were observed at 1 year between the groups (p < 0.01).
  • Key risk factors identified by Lasso regression included grouping, bone mineral density T-value, and 3-month post-operative UCLA score.
  • A predictive model was developed using these significant variables.

Conclusions:

  • Modified double-row biceps tenodesis with pulley ring repair demonstrates superior long-term glenohumeral joint function compared to traditional MDBT.
  • This technique aids in better restoration of the glenohumeral joint's biological state.
  • Pulley ring repair is a valuable adjunct to MDBT for optimizing outcomes in SLAP lesion treatment.