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Article

Ultrasound-Guided Percutaneous Tenotomy of the Long Head of Biceps Tendon in Patients with Symptomatic Complete Rotator Cuff Tear: In Vivo Non-contRolled Prospective Study

1
IRCCS Istituto Ortopedico Galeazzi, 20161 Milano, Italy
2
Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20133 Milano, Italy
3
Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, 90127 Palermo, Italy
4
ASST Pini-CTO, 20122 Milano, Italy
5
RECAP-RD, Università degli Studi di Milano, 20133 Milano, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(7), 2114; https://doi.org/10.3390/jcm9072114
Received: 20 May 2020 / Revised: 18 June 2020 / Accepted: 2 July 2020 / Published: 4 July 2020
(This article belongs to the Special Issue Orthopaedic Diseases and Rehabilitation)
Background: We prospectively tested technical feasibility and clinical outcome of percutaneous ultrasound-guided tenotomy of long head of biceps tendon (LHBT). Methods: We included 11 patients (6 women; age: 73 ± 8.6 years) with symptomatic full-thickness rotator cuff tear and intact LHBT, in whom surgical repair was not possible/refused. After ultrasound-guided injection of local anesthetic, the LHBT was cut with a scalpel under continuous ultrasound monitoring until it became no longer visible. Pain was recorded before and at least six months after procedure. An eight-item questionnaire was administered to patients at follow-up. Results: A median of 4 tendon cuts were needed to ensure complete tenotomy. Mean procedure duration was 65 ± 5.7 s. Mean length of skin incision was 5.8 ± 0.6 mm. Pre-tenotomy VAS score was 8.2 ± 0.7, post-tenotomy VAS was 2.8 ± 0.6 (p < 0.001). At follow-up, 5/11 patients were very satisfied, 5/11 satisfied and 1/11 neutral. One patient experienced cramping and very minimal pain in the biceps. Six patients had still moderate shoulder pain, 1/11 minimal pain, 2/11 very minimal pain, while 2/11 had no pain. No patients had weakness in elbow flexion nor limits of daily activities due to LHBT. One patient showed Popeye deformity. All patients would undergo ultrasound-guided tenotomy again. Conclusion: ultrasound-guided percutaneous LHBT tenotomy is technically feasible and effective. View Full-Text
Keywords: shoulder; long head of biceps tendon; tenotomy; ultrasound; ultrasound-guided procedure; percutaneous; pain shoulder; long head of biceps tendon; tenotomy; ultrasound; ultrasound-guided procedure; percutaneous; pain
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MDPI and ACS Style

Sconfienza, L.M.; Albano, D.; Messina, C.; Gitto, S.; Guarrella, V.; Perfetti, C.; Taverna, E.; Arrigoni, P.; Randelli, P.S. Ultrasound-Guided Percutaneous Tenotomy of the Long Head of Biceps Tendon in Patients with Symptomatic Complete Rotator Cuff Tear: In Vivo Non-contRolled Prospective Study. J. Clin. Med. 2020, 9, 2114. https://doi.org/10.3390/jcm9072114

AMA Style

Sconfienza LM, Albano D, Messina C, Gitto S, Guarrella V, Perfetti C, Taverna E, Arrigoni P, Randelli PS. Ultrasound-Guided Percutaneous Tenotomy of the Long Head of Biceps Tendon in Patients with Symptomatic Complete Rotator Cuff Tear: In Vivo Non-contRolled Prospective Study. Journal of Clinical Medicine. 2020; 9(7):2114. https://doi.org/10.3390/jcm9072114

Chicago/Turabian Style

Sconfienza, Luca Maria, Domenico Albano, Carmelo Messina, Salvatore Gitto, Vincenzo Guarrella, Carlo Perfetti, Ettore Taverna, Paolo Arrigoni, and Pietro Simone Randelli. 2020. "Ultrasound-Guided Percutaneous Tenotomy of the Long Head of Biceps Tendon in Patients with Symptomatic Complete Rotator Cuff Tear: In Vivo Non-contRolled Prospective Study" Journal of Clinical Medicine 9, no. 7: 2114. https://doi.org/10.3390/jcm9072114

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