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PubMed2005

Subpectoral biceps tenodesis with interference screw fixation.

The proximal portion of the long head of the biceps is a recognized cause of anterior shoulder pain. This article presents a novel technique for tenodesing the proximal biceps tendon. The tendon is evaluated and tenodesed in the same anatomic position beneath the pectoralis tendon, and is removed entirely from the bicipital groove. The proximal portion of the long head of the biceps tendon is marked near its origin and lysed arthroscopically. The skin incision for the subpectoral open biceps tenodesis is made in the axilla exposing the inferior border of the pectoralis major muscle. The tendon is withdrawn from the joint and out of the incision. A Krackow or other type of interrupted tendon whipstitch is placed in the 10 to 15 mm of tendon proximal to the musculotendinous junction. A bone tunnel is created within the bicipital groove. The tendon/tenodesis driver complex is positioned to create a secure fit within the bone tunnel. Our current series includes 22 cases with short-term follow-up of 2 to 10 months. None of the repairs has pulled out and none of the patients reports persistent pain or loss of function. The subpectoral approach with interference screw fixation appears to be a promising, reproducible technique for tenodesing the biceps.

Bone Screws↗
PubMed2006

Three-ligament tenodesis for the treatment of scapholunate dissociation: indications and surgical technique.

Different surgical techniques have been proposed to treat traumatic scapholunate instability. Deciding which treatment is best for each individual case is not easy. In this article we report an algorithm of treatment based on a number of prognostic factors that may help in this matter. We also report on the promising results obtained using a new technique, the 3-ligament tenodesis, for the treatment of nonrepairable complete scapholunate ligament rupture, causing a reducible carpal malalignment without secondary osteoarthritis. This technique incorporates features from 3 previously described techniques.

Adolescent↗
PubMed1996

Electrical stimulation and biofeedback effect on recovery of tenodesis grasp: a controlled study.

OBJECTIVE: Evaluate the effectiveness of electrical stimulation and biofeedback on the recovery of tenodesis grasp in tetraplegic individuals during the initial phase of acute rehabilitation. DESIGN: A 2 x 2 block design was used with subjects randomized to treatment groups. Forty-five subjects completed the study. SETTING: Inpatient occupational therapy department. SUBJECTS: Inpatients with tetraplegia, first admission for rehabilitation after an acute spinal cord injury. INTERVENTIONS: The four treatment groups were: conventional treatment, electrical stimulation, biofeedback, and combined electrical stimulation and biofeedback. The treatment period was between 5 and 6 weeks. MAIN OUTCOME MEASURES: Manual muscle testing and scoring of activities of daily living performance by a blinded evaluator. RESULTS: All four treatment groups showed improvements. No treatment group was superior to the others. CONCLUSIONS: Biofeedback and electrical stimulation alone or in combination offer no advantages over conventional rehabilitation treatment of wrist extensors in tetraplegic patients after spinal cord injury.

Activities of Daily Living↗
PubMed1983

Modified Parkes tenodesis in claw hand.

The purpose of this report is to present observations on a modified Parkes tenodesis operation for correction of paralytic claw fingers. The long-term results were evaluated in eight adult patients with an observation time of two to six years. As compared to the findings four months after the operation, the results had not deteriorated with time and were found to be good in six patients and fair in two patients.

Fingers↗
PubMed2002

Comparing and contrasting methods for tenodesis of the ruptured distal biceps tendon.

The evidence is clear that anatomic reinsertion is the best treatment for an active, compliant patient with an acute distal biceps rupture or a subacute rupture without significant proximal retraction of the tendon. Patients with partial tears and chronic ruptures require surgical attention when persistently symptomatic. Biceps tenodesis through dual incisions or a single anterior incision is a safe, highly reliable, and effective operation. The posterior interosseous nerve is potentially at risk with either approach. This risk is minimized by avoiding exposure and retraction of the nerve. Heterotopic ossification and subsequent proximal radio-ulnar synostosis are reported complications of the two-incision technique. The incidence of this devastating complication has been reduced, but not eliminated, by using a limited posterior forearm muscle-splitting incision and by not exposing the ulna. It is the authors' belief that a single anterior incision with suture anchor fixation of the distal biceps (in the manner described herein) is the surgical treatment of choice for most distal biceps ruptures. Compared with the two-incision method, the posterior interosseous nerve is at no more risk and the chance of heterotopic ossification is diminished. The secure fixation obtained and the limited surgical exposure required allow for early mobilization and rapid return of function.

Elbow Joint↗
PubMed2001

Semitendinosus tenodesis for medial instability of the knee.

A new technique of semitendinosus tenodesis has been developed to treat medial instability of the knee. The semitendinosus tendon was sectioned at the musculotendinous junction. The accessory insertion of the tendon was dissected to be overlapping and parallel to the anterior band of the medial collateral ligament. An isometric point on the femur was located around the medial epicondyle. A bony trough was created just above the isometric point and a screw with washer was placed. The semitendinosus tendon was looped around the screw and the screw was tightened to hold the tendon in place. The free end of the tendon was pulled obliquely backward and passed through the insertion of the direct head of the semimembranosus tendon to reconstruct the posterior oblique ligament. The semitendinosus tendon reinforced both the medial collateral ligament and the posterior oblique ligament.

Bone Wires↗
PubMed2002

Split distal flexor pollicis longus tenodesis: long-term results.

A thumb lacking intrinsic muscle function but having extrinsic flexion will hyperflex in the interphalangeal joint giving a positive Froment's sign. This can effectively be prevented with split flexor pollicis longus tenodesis. The mean postoperative range of motion in the IP joint of 39 hands was 28 (18) degrees and 23 (20) degrees six and 12 months postoperatively. The procedure makes arthrodesis (temporary or permanent) superfluous. This procedure can be recommended strongly.

Finger Joint↗
PubMed2006

Tenodesis extension splinting for radial nerve palsy.

Injuries to the radial nerve or posterior interosseous nerve can lead to significant functional limitation. Inability to extend the wrist and/or digits prevents the hand from being positioned properly for functional tasks. Therapy after radial nerve injury is geared toward maintaining passive extension of the wrist and digits. Sensory reeducation can also be performed but often not necessary since the distribution of the nerve distally is on the dorsoradial surface of the hand. Since nerve regeneration is often a lengthy process and the extent of recovery is variable, splinting the involved extremity is used to prevent contractures and maximize function. This article introduces a new splint that allows patients to extend the fingers and thumb via a tenodesis effect at the wrist. In early trials, it has produced excellent results for enhancing functional use of the injured extremity while nerve regeneration occurs or until tendon transfers have been performed.

Equipment Design↗
PubMed2003

Treatment of bicipital tenosynovitis with double tenodesis.

This report describes two dogs with bilateral bicipital tenosynovitis which were managed using double tenodesis. Surgical repair involved the attachment of the tendon to the humerus with a bone screw and plastic spiked washer, and a double Bunnell-Meyer suture. Six months postoperatively, neither of the treated dogs displayed any lameness on clinical examination.

Animals↗
PubMed1993

Watson-Jones tenodesis for chronic ankle joint instability.

Twenty-three patients (22 soldiers and 1 civilian) were admitted to the Cambridge Military Hospital between May 1990 and May 1992 with chronic inversion instability of an ankle and underwent Watson-Jones Tenodesis. A retrospective study was carried out to evaluate their results.

Ankle Injuries↗
PubMed1993

Extra-articular tenodesis for anterior cruciate deficient knees: a review of the Ellison repair.

Twenty-two patients who underwent an Ellison extra-articular tenodesis for anterolateral instability of the knee, performed by one surgeon (SCC), have been reviewed after a mean follow-up of 59 months. Seventy-seven per cent had a good or excellent result enabling them to return to their pre-injury level of sport. These results compare very favourably with intra-articular repair but are not associated with such severe complications.

Adult↗
PubMedDate not supplied

Long-term study of anterior cruciate ligament reconstruction for chronic instability using the central one-third patellar tendon and a lateral extraarticular tenodesis.

Forty-four patients with symptomatic chronic anterior cruciate ligament instabilities that had been reconstructed with the central one-third patellar tendon and a lateral extraarticular iliotibial band tenodesis were studied at an average followup of 7 years (range, 4 to 10). The cases with associated medial, lateral, or posterior laxity were not included, nor were the cases with more than minimal preoperative degenerative changes. The average age at surgery was 21 years (range, 16 to 33). A postoperative cast was used for 4 weeks. Satisfactory objective stability, which was defined as a KT-1000 side-to-side difference of up to 5 mm at the manual maximum test, was obtained in 37 (84%) of the patients. In 25 patients (57%), stability was restored within normal limits (less than or equal to 3 mm). No deterioration of the KT-1000 stability was noted at two follow-up visits performed by the same examiner (at an average of 4 and 7 years). A return to high-risk sports was possible in 27 (62%) of the patients. Difficulties in regaining a complete range of motion were recorded in 5 (11%) of the patients. A flexion contracture of 5 degrees to 7 degrees was also found in 5 patients. Significant patellofemoral symptoms were present in 4 patients (9%). A 5% to 11% shortening of the patella tendon was observed in 14 (32%) of the knees, but did not correlate with patellar problems. Moderate radiographic changes were noted in eight patients (18%) at followup and correlated with meniscectomy and pain. Overall satisfactory results were obtained in this initial experience in 29 (66%) of the patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Anterior cruciate ligament reconstruction using the semitendinosus and gracilis tendons augmented by the losee iliotibial band tenodesis. A long-term study.

Seventy patients were evaluated after combined intra- and extraarticular reconstruction of the anterior cruciate ligament. Semitendinosus and gracilis tendons were used for the intraarticular reconstruction and Losee iliotibial band tenodesis for the extraarticular procedure. Minimum followup was 5 years (average, 7). Clinical examination and instrumented ligament examination with the KT-1000 arthrometer and the Cybex II dynamometer were used to evaluate results. Subjectively, patients had no complaints of instability with daily activities; 93% had no complaints of instability with athletic participation. Clinical examination demonstrated that 81% had less than a 1 + Lachman test; 98% had a negative pivot shift. Instrumented examination of the anteroposterior limits of motion revealed that only 57% had less than 3-mm side-to-side difference; 30% had 3- to 5-mm; and 13% had 6- to 9-mm. Mean hamstring muscle strength measured with the Cybex II dynamometer was 94% at 60 and 96% at 100 deg/sec. When evaluated with the Zarins scale, 90% were rated good or excellent, 6% fair, and 4% poor. This reconstructive procedure restores functional, but not necessarily normal, stability in most anterior cruciate ligament-deficient knees. It allows patients to increase activity levels without significant risk of additional injuries.

Adult↗
PubMed2004

Surgical correction of crossover deformity of the second toe: a technique for tenodesis.

Twenty-seven patients with 30 crossover toe (COT) deformities of the second toe were evaluated. This deformity in the transverse and sagittal planes at the second metatarsophalangeal joint may be caused by hindfoot pronation. Compression of the lateral plantar nerve may produce incompetence of the second dorsal interosseous muscle and an increased extension-adduction pull by the lumbrical and first dorsal interosseous muscles. A surgical procedure for tenodesis is described to correct these deformities and restore the extrinsic-intrinsic musculotendinous balance at the second MTP joint. Our results are encouraging, with 83% good or excellent results. There was one recurrence.

Aged↗
PubMed1996

Results of hallux varus correction using an extensor hallucis brevis tenodesis.

We have used an extensor hallucis brevis tenodesis procedure to treat symptomatic hallux varus in six patients (five women and one man). Indications for this procedure include the presence of flexible metatarsophalangeal and interphalangeal joints and the absence of arthritis. In this group (mean age, 47 years; range, 18-65 years), hallux varus followed correction of hallux valgus deformity in five patients and traumatic dislocation of the hallux in one patient. Excellent correction was noted and maintained in all patients at a mean interval of 28 months (range, 24-32 months) after surgery. Despite a slight decrease in dorsiflexion following surgery (average, 10 degrees), there were no additional complications noted, and the mean American Orthopaedic Foot and Ankle Society rating score improved from 61 to 85 after surgery.

Adolescent↗
PubMed1999

Clinical and functional outcome after anatomic and nonanatomic ankle ligament reconstruction: Evans tenodesis versus periosteal flap.

The present study investigated the effects of two different surgical procedures for the treatment of chronic ankle instability. Ten patients treated with an anatomic reconstruction using a periosteal flap were compared with a second group that received an Evans tenodesis. All patients were evaluated before and after surgery with clinical and radiographic examinations as well as dynamic pedobarography. Patient satisfaction and radiographic and functional results were comparable in both groups and revealed a good restoration of joint stability and gait symmetry. Our results indicate that both methods of ankle ligament reconstruction achieve a comparable clinical and functional outcome within 1 year after surgery.

Adult↗