The severity of the long head biceps tendinopathy in patients with chronic rotator cuff tears: macroscopic versus microscopic results

Background This study investigated the histopathology of the long head of biceps (LHB) tendon and correlated the findings with the macroscopic appearances of the LHB and the size of rotator cuff tears (RCTs) in patients with chronic RCTs. Methods We compared biopsy specimens from LHBs in 34 patients...

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Published in:Journal of shoulder and elbow surgery 2014-08, Vol.23 (8), p.1099-1106
Main Authors: Wu, Po-Ting, MD, Jou, I-Ming, MD, PhD, Yang, Cheng-Chang, MSc, Lin, Chii-Jeng, MD, PhD, Yang, Chyun-Yu, MD, PhD, Su, Fong-Chin, PhD, Su, Wei-Ren, MD, MSc
Format: Article
Language:English
Subjects:
Aged
apoptosis
Arm Injuries - pathology
Chronic Disease
Female
Humans
Long head of biceps
Male
Middle Aged
Orthopedics
Rotator Cuff - pathology
Rotator Cuff - surgery
Rotator Cuff Injuries
rotator cuff tear
shoulder pain
tendinopathy
Tendinopathy - pathology
tenotomy/tenodesis
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Summary:Background This study investigated the histopathology of the long head of biceps (LHB) tendon and correlated the findings with the macroscopic appearances of the LHB and the size of rotator cuff tears (RCTs) in patients with chronic RCTs. Methods We compared biopsy specimens from LHBs in 34 patients with chronic RCTs and grossly normal LHBs in 8 patients undergoing shoulder hemiarthroplasty (controls). Duration of preoperative symptoms, the severity of RCTs, and macroscopic appearance of LHBs were recorded, classified, and compared with the histologic grading and apoptosis index of terminal deoxynucleotide transferase-mediated biotin-deoxy uridine triphosphate nick-end labeling (TUNEL) assays of LHBs. Results In the RCT group, there were 8 partial-thickness tears with 5 macroscopic LHB lesions, 12 full-thickness tears with 8 macroscopic LHB lesions, and 14 massive tears with 13 macroscopic LHB lesions. There were 6 LHB subluxations. However, the macroscopic grading and the symptom duration were not correlated with the severity of the histology. In patients with massive tears, no matter what the macroscopic appearance of the LHB, the proportion of end-stage (grade 4) histologic LHB tendinopathy significantly increased (85.7%, P  
ISSN:1058-2746
1532-6500
DOI:10.1016/j.jse.2013.11.013