Proximal Biceps

1,203 views

Published on

Presentation for Pacific Medical PA Lab, Tracy CA, July 2012

Published in: Health & Medicine
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
1,203
On SlideShare
0
From Embeds
0
Number of Embeds
44
Actions
Shares
0
Downloads
0
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Proximal Biceps

  1. 1. Biceps: Below the Groove Alan M. Hirahara, M.D., FRCS(C) Board Certified in Orthopaedic Surgery & Orthopaedic Sports Medicine Specializing in arthroscopic shoulder surgery Medical Director Team Physician ConsultantSacramento State Athletics Sacramento River Cats Oakland A’s MiLB - AAA
  2. 2. Proximal Fixation• Potential failures – Intra-groove pathology – Poor fixation in proximal humerus – Technically challenging
  3. 3. Localization of Biceps/Notch
  4. 4. A Clinical Evaluation of a New Arthroscopic Biceps Tenodesis Technique Alan M Hirahara, MD, FRCSC*Presented @ AANA, WOA, & COA 2012
  5. 5. Study Design• Case-control study design• 14 patients with Biceps Tenodesis / 9 patients with Tenotomy• Collection period: 12/09 – 9/11• Pain scores, ASES scores taken every month for 6 months – ROM measured pre-op and monthly for 3 months post – Date of discharge and date of return to work noted
  6. 6. Surgical Technique
  7. 7. Results Pain Scores ASES Scores p = NS p = 0.03 p=NS p = NS p = 0.01 p=NS p = 0.048.0 90.07.0 80.0 70.06.0 60.05.0 50.04.0 40.03.0 30.02.0 20.01.0 10.00.0 0.0 Pre-op 1 2 3 4 5 6 Pre-op 1 2 3 4 5 6 Month Month Month Month Month Month Month Month Month Month Month Month  Control Group: n = 9  Study Group: n = 14
  8. 8. Results• No pull-outs of tenodesis• Statistical significant difference in: – VAS pain scores at 3 months only – ASES scores at 3, 5, & 6 months• No statistical significance in: – Return to work – Time to discharge
  9. 9. Conclusion• Biceps tenodesis results in: – Significantly less pain – Significantly higher function – But does carry a risk of conversion to tenotomy if pull out occurs• However, this simple arthroscopic technique is easy, reproducible and yields outstanding results compared with tenotomy• Avoids complications associated with proximal fixation
  10. 10. Fork Technique
  11. 11. Thank You!

×