Histopathology of long head of biceps tendon removed during tenodesis demonstrates degenerative histopathology and not inflammatory changes

BMC Musculoskeletal Disorders

William D. Regan¹  Maciej J. K. Simon²  Jane Yeoh³  Jennifer Nevin³  Michael Nimmo⁴ 

[1] Department of Orthopaedics, Chan Gunn Pavilion, Allen McGavin Sports Medicine Clinic, University of British Columbia, 2553 Wesbrook Mall, V6T1Z3, Vancouver, BC, Canada;Department of Orthopaedics, Chan Gunn Pavilion, Allen McGavin Sports Medicine Clinic, University of British Columbia, 2553 Wesbrook Mall, V6T1Z3, Vancouver, BC, Canada;Department of Orthopaedics and Trauma Surgery, University Medical Center Schleswig-Holstein - Campus Kiel, Arnold-Heller-Str. 3, 24105, Kiel, Germany;Department of Orthopaedics, University of British Columbia, 2775 Laurel Street, 11th Floor, V5Z1M9, Vancouver, BC, Canada;Department of Pathology, University of British Columbia, 910 West 10th Avenue, Room 135C, V5Z4E3, Vancouver, BC, Canada;

关键词: Long head of biceps tendon;    Tendinopathy;    Tendinosis;    Shoulder histology;    Histopathology;    Outcomes;   

DOI  :  10.1186/s12891-022-05124-z

来源: Springer

【 摘 要 】

BackgroundThe aim of this study is to describe and quantitatively analyze the histopathology of proximal long head biceps (LHB) tendinopathy in patients who have undergone LHB tenodesis. The hypothesis is that severe histopathologic changes of the LHB tendon (LHBT) will most likely be reflected with improved postoperative clinical outcomes.MethodsThe study included patients with isolated LHB tendinopathy or LHB tendinopathy associated with concomitant shoulder pathologies. All had failed conservative treatment (12 months) and had a positive pain response (> 50% reduction) pre-operatively after LHB tendon injection with local anesthetic. All underwent biceps tenodesis procedure between 2008 and 2014. Tendon specimens were collected and histologically analyzed with the semi-quantitative Bonar scoring system. Minimum follow-up time was 1 year. A subset of patients was retrospectively reviewed postoperatively and evaluated employing visual analogue score (VAS), short form survey (SF-12), American Shoulder and Elbow Surgeon (ASES) score, Disability of Arm, Shoulder and Hand (DASH) score, and Oxford Shoulder Score (OSS) and postoperative return to work status.ResultsForty-five biceps tendon specimens were obtained from 44 patients (mean age 50 ± 9.6 years). Histopathological analyses demonstrated advanced degenerative changes with myxoid degeneration and marked collagen disorganization. Minimal inflammation was identified. There were no regional differences in histopathological changes. Clinical outcomes did not correlate significantly with severity of histopathologic changes.ConclusionsThis study confirms that LHBT specimens in patients undergoing tenodesis demonstrate with the use of the Bonar score histopathologic changes of chronic degeneration and not inflammation. The correct histopathologic terminology for this process is LHB tendinosis. The histopathological changes appear uniform throughout the entire length of the LHBT which may inform the nature of the procedure performed.

【 授权许可】

CC BY