Humeral head abrasion: An association with failed superior labrum anterior posterior repairs.
Summary of "Humeral head abrasion: An association with failed superior labrum anterior posterior repairs."
An abrasion on the humeral head under the articulating portion of the biceps tendon has been observed in patients with pain and stiffness after superior labrum anterior posterior (SLAP) repair. This study examined this humeral head abrasion (HHA) and its association with various diagnoses involving pathology of the biceps-labral complex. We hypothesized that it would be more common in failed SLAP repairs than other diagnoses. MATERIALS AND
A retrospective chart review was performed of 253 patients who underwent shoulder arthroscopy by a single surgeon during a 5-year period. Postoperative diagnoses were used to confirm one of the following diagnoses: failed SLAP repair, biceps tendonitis, SLAP lesion with biceps tendonitis, and isolated SLAP lesion. Operative reports and surgical images were analyzed to identify the presence or absence of HHA. Demographic data, including age, sex, handedness, and onset of injury, were also collected. The frequency of this lesion among the different diagnoses and patient characteristics was compared by χ(2) analysis.
HHA was observed in 13 of 18 patients (72.2%) with failed SLAP repairs, in 8 of 18 (44.4%) with biceps tendonitis, in 11 of 20 (55%) with SLAP lesion and biceps tendonitis, and in 1 of 71 (1.4%) with isolated SLAP lesions, significantly differing in frequency by diagnosis (P < .001). Patients with HHA were an older median age than those without (48 vs 40; P = .004).
HHA is common in patients with a pathologic biceps-labral complex, especially those with failed SLAP repair. We speculate that this lesion is due to inflammation of the biceps tendon resulting in increased biceps-humeral head contact pressure.
Vanderbilt Sports Medicine, Nashville, TN.
This article was published in the following journal.
Name: Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.]
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20863719
- DOI: http://dx.doi.org/10.1016/j.jse.2010.05.013
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Medical and Biotech [MESH] Definitions
Compression of the rotator cuff tendons and subacromial bursa between the humeral head and structures that make up the coracoacromial arch and the humeral tuberosities. This condition is associated with subacromial bursitis and rotator cuff (largely supraspinatus) and bicipital tendon inflammation, with or without degenerative changes in the tendon. Pain that is most severe when the arm is abducted in an arc between 40 and 120 degrees, sometimes associated with tears in the rotator cuff, is the chief symptom. (From Jablonski's Dictionary of Syndromes and Eponymic Diseases, 2d ed)
The portion of the upper rounded extremity fitting into the glenoid cavity of the SCAPULA. (from Stedman, 27th ed)
A condition that occurs when the obstruction of the thin-walled SUPERIOR VENA CAVA interrupts blood flow from the head, upper extremities, and thorax to the RIGHT ATRIUM. Obstruction can be caused by NEOPLASMS; THROMBOSIS; ANEURYSM; or external compression. The syndrome is characterized by swelling and/or CYANOSIS of the face, neck, and upper arms.
The venous trunk which returns blood from the head, neck, upper extremities and chest.
Diseases of the fourth cranial (trochlear) nerve or its nucleus in the midbrain. The nerve crosses as it exits the midbrain dorsally and may be injured along its course through the intracranial space, cavernous sinus, superior orbital fissure, or orbit. Clinical manifestations include weakness of the superior oblique muscle which causes vertical DIPLOPIA that is maximal when the affected eye is adducted and directed inferiorly. Head tilt may be seen as a compensatory mechanism for diplopia and rotation of the visual axis. Common etiologies include CRANIOCEREBRAL TRAUMA and INFRATENTORIAL NEOPLASMS.