Tenotomy in the treatment of spastic paraplegia; with special reference to tenotomy of the iliopsoas.
Explore the source record for details and available documents.
Muscle Spasticity↗
SEARCH · PubMed Health
Results for “Tenotomy”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Effects of extraocular muscle tenotomy on congenital nystagmus in macaque monkeys.
INTRODUCTION: Extraocular muscle tenotomy has been reported to damp congenital nystagmus in an achiasmatic sheepdog. We performed extraocular muscle tenotomy to evaluate its effects on congenital nystagmus in primates. METHODS: Magnetic search coil eye movement recordings were used to document the presence of horizontal congenital nystagmus in 2 adult macaque monkeys that also had naturally occurring infantile strabismus. Extraocular muscle tenotomy was performed by operating on all 4 horizontal recti, surgically detaching the muscles from the globe and suturing them back to their original insertions without resection or recession. Eye movement recordings were repeated 4 months after the procedure, comparing the waveform, amplitude, retinal slip velocity, and intensity (frequency x amplitude) of the nystagmus before and after tenotomy. Visual acuity was also measured before and after surgery in 1 animal. RESULTS: Preoperatively, a disconjugate, pendular nystagmus was evident in 1 monkey, and the other had a conjugate pendular-jerk nystagmus damped by convergence. After tenotomy, nystagmus mean amplitude decreased 18% to 52% in 1 monkey but increased 14% in the other (t test, P <.002). Retinal slip velocity and nystagmus intensity increased in both monkeys. After tenotomy, mean velocity increased 22% to 218%, while mean intensity increased 40% to 208% (t test, P <.002). Visual acuity measured after tenotomy decreased an average of 20% ( approximately 2.0 cycles per degree) in each eye. Tenotomy had no noteworthy effects on eye alignment or other aspects of visual behavior other than the congenital nystagmus. CONCLUSION: Nystagmus velocity and intensity increased after extraocular muscle tenotomy in 2 monkeys. Further studies are required to establish the clinical value of this procedure as a treatment for various subtypes of congenital nystagmus in humans.
Animals↗
Comparison of superior oblique tendon expander to superior oblique tenotomy for the management of superior oblique overaction and Brown syndrome.
We compared surgical results of superior oblique tenotomy to the superior oblique silicone expander for the treatment of superior oblique overaction and Brown syndrome. Of 24 patients with bilateral superior oblique overaction, 13 underwent tenotomy and 11 had the silicone expander procedure. Reduction of A-pattern to within 10 prism diopters was achieved in 12/13 (92.3%) tenotomy patients and in 10/11 (90.9%) patients undergoing silicone expander (P greater than .05). Correction of superior oblique overaction on versions to within +/- 1 dysfunction was achieved in 22/26 (84.6%) of the tenotomies, and 21/22 (95.5%) silicone expander procedures (P greater than .05). Zero superior oblique dysfunction was found after 14/26 (53.8%) tenotomy procedures versus 18/22 (81.8%) silicone expander operations (P = .041). Superior oblique paresis occurred postoperatively in 4/13 (30.8%) tenotomy patients, whereas none of the 11 patients in the silicone expander group had superior oblique paresis (P = .044). Six patients who underwent superior oblique tenotomy for superior oblique overaction had preoperative stereopsis; following surgery, only two maintained the same level of stereopsis, and three patients totally lost all stereo acuity. All patients in the silicone expander group either maintained or had improved stereo acuity postoperatively. Seven patients with true Brown syndrome were operated on: three underwent the silicone expander procedure and four had a superior oblique tenotomy with an ipsilateral inferior oblique recession. The combination of superior oblique tenotomy with simultaneous ipsilateral inferior oblique recession resulted in an undercorrection in two of the four patients, whereas all three patients in the silicone expander group showed excellent ocular motility postoperatively, with two having normal versions and one a -1 residual limitation.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
S-ketoprofen inhibits tenotomy-induced bone loss and dynamics in weanling rats.
The objects of this study were to determine whether S-Ketoprofen, a non-steroidal anti-inflammatory drug (NSAID), can prevent immobilization (tenotomy)-induced bone loss in weanling rats. Forty-five 4-week-old Sprague-Dawley female rats were either sham-operated or subjected to knee tenotomy and treated simultaneously with 0, 0.02, 0.1, 0.5 or 2.5 mg of S-ketoprofen/kg per day for 21 days. We then studied double-fluorescent labeled proximal tibial longitudinal sections and tibial shaft cross sections using static and dynamic histomorphometry. Less cancellous bone mass in proximal tibial metaphyses was found in tenotomized controls than in basal (36%) and sham-operated (54%) controls. This was due to the inhibition of age-related bone gain and induced bone loss due to increased bone resorption and decreased bone formation. S-ketoprofen prevented both the inhibition of age-related bone gain and the stimulation of bone loss at the 2.5 mg/kg per day dose level, while it only prevented bone loss at the 0.5 mg/kg dose levels. In cancellous bone, dynamic histomorphometry showed that S-ketoprofen prevented the tenotomy induced decrease in bone formation and increase in bone resorption. In the tibial shaft, tenotomy inhibited the enlargement of total tissue area by depressing periosteal bone formation, and thus inhibited age-related cortical bone gain. S-ketoprofen treatment did not prevent this change at all dose levels, but reduced marrow cavity area to increase cortical bone area at the 0.1, 0.5 and 2.5 mg/kg per dose levels compared to tenotomy controls. However, the cortical bone area in the 0.1 and 0.5 mg dose-treated tenotomy rats was still lower than in the age-related controls. S-ketoprofen also prevented the increase in endocortical eroded perimeter induced by tenotomy. In summary, tenotomy inhibited age-related bone gain and stimulated bone loss in cancellous bone sites, and only inhibited age-related bone gain in cortical bone sites. S-ketoprofen treatment at the highest dose levels prevented the changes in cancellous bone, and reduced marrow area to increase cortical bone in the tibial shafts.
Animals↗
Predicting the need for tenotomy in the Ponseti method for correction of clubfeet.
The purpose of this study was to determine how to predict the need for tenotomy at the initiation of the Ponseti treatment. Fifty clubfeet (35 patients) were prospectively rated according to Pirani and Dimeglio scoring systems. Tenotomies were performed in 36 of 50 feet (72%). Those that underwent tenotomy required significantly more casts (P = 0.005). Of 27 feet with initial Pirani scores > or = 5.0, 85.2% required a tenotomy and 14.8% did not; 94.7% of the Dimeglio Grade IV feet required tenotomies. Following removal of the last cast, there was no significant difference between those that did and did not have a tenotomy. Children with clubfeet who have an initial score of > or = 5.0 by the Pirani system or are rated as Grade IV feet by the Dimeglio system are very likely to need a tenotomy. At the end of casting, feet were equally well corrected whether or not they needed a tenotomy.
Achilles Tendon↗
Open and arthroscopic patellar tenotomy for chronic patellar tendinopathy. A retrospective outcome study. Victorian Institute of Sport Tendon Study Group.
Chronic patellar tendinopathy often requires surgical treatment. We compared the outcomes in 25 subjects (29 tendons) who had had open patellar tenotomy and 23 subjects (25 tendons) who had had arthroscopic patellar tenotomy at a mean follow-up of 3.8 and 4.3 years, respectively. At follow-up, outcomes in the open and arthroscopic groups were as follows: 1) symptomatic benefit was seen in 81% of open and 96% of arthroscopic tenotomy patients, 2) sporting success was seen in 54% of open and 46% of arthroscopic tenotomy patients, 3) median time to return to preinjury level of activity was 10 months for open and 6 months for arthroscopic tenotomy patients, and 4) median Victorian Institute of Sport Assessment score at follow-up was 88 for open and 77 for arthroscopic tenotomy patients. There were no significant differences between groups for all outcomes. The appearance of the tendon on sonography remained abnormal in over 70% of subjects at follow-up, and sonographic appearance did not correlate with clinical outcome. Thus, arthroscopic patellar tenotomy was as successful as the traditional open procedure. Both procedures provided virtually all subjects with symptomatic benefit, but only about half the subjects who underwent either open or arthroscopic patellar tenotomy were competing at their former sporting level at follow-up.
Adolescent↗
Effect of tenotomy on extensor digitorum longus muscle in Sprague Dawley rats.
The effect of tenotomy on Extensor Digitorum Longus (EDL) muscle, brought about by removal of anterior tibialis muscle was studied in the rat. Hypertrophy as well as hyperplasia of the muscle fibres were observed following tenotomy of intact muscle. The transplanted muscle regenerated after tenotomy in the form of a flat strap. The weight, length, breadth and total muscle area of intact muscle increased but decreased in transplanted muscle following tenotomy. The number of muscle fibres/microscopic field increased during the entire experiment in intact muscle after tenotomy, while in transplant the number of fibres first decreased and then increased. The diameter of intact and transplanted muscle increased after tenotomy. The number and diameter of nuclei was normalized at the end of experiment in both groups. The DNA and RNA content was increased in intact muscle after tenotomy. In transplant DNA and RNA content first increased but than decreased. The protein content was increased in intact muscle at the end of the experiment but decreased in transplant after tenotomy.
Animals↗
Central slip tenotomy for the treatment of chronic mallet finger: an anatomic study.
PURPOSE: Tenotomy of the central slip, described by Fowler, can clinically improve chronic distal interphalangeal joint (DIP) extensor lag secondary to mallet finger (terminal tendon disruption). The goal of this study is to evaluate the potential of central slip tenotomy to restore DIP joint extension. METHODS: A mallet deformity was reproduced in 15 fresh-frozen cadaver fingers after the extensor tendon insertion was sectioned over the DIP joint. A suture anchor inserted at the terminal insertion was then secured to the extensor tendon over the middle phalanx to reconstruct the extensor mechanism. A 500-g weight attached to the proximal extensor tendon applied extensor tension. Central slip tenotomy was then performed. DIP extensor lags before and after tenotomy were recorded. RESULTS: After sectioning of the terminal tendon over the DIP joint the average amount of extensor tendon lag produced was 45 degrees. After central slip tenotomy was performed the average amount of extensor lag correction was 36 degrees (range, 30 degrees-46 degrees). CONCLUSIONS: Several clinical studies have shown that central slip tenotomy is an effective treatment for chronic mallet finger but may not fully restore DIP joint extension. Our data suggest that patients with a pre-existing extensor lag of greater than 36 degrees may not achieve full extension from central slip tenotomy, although extensor lags of up to 46 degrees may be corrected.
Adult↗
Microvascular change of the anterior eye segment after tenotomy in the rabbit.
BACKGROUND: The microvascular changes secondary to anterior segment ischemia following tenotomy of the extraocular muscles have not been studied in the rabbit. METHODS: Using scanning electron microscopy of methyl-methacrylate ocular microvascular luminal castings, the anterior eye segment vasculature after tenotomy was documented and compared to that after occlusion of the bilateral long posterior ciliary arteries and that in the eyes that were not subjected to any surgical intervention. RESULTS: Five days and 1 week after the surgical intervention with tenotomy, microvascular change secondary to the anterior segment ischemia was not apparent, but 2 weeks after the tenotomy subtle evidence of ischemia such as new vessels in the iris was observed. Seven weeks after tenotomy, marked microvascular change was observed where corneal new vessels arose from the superior perilimbal arteries. In contrast, we found prominent microvascular changes 2 weeks after the occlusion of the long posterior ciliary arteries. CONCLUSIONS: Tenotomy of the rabbit eye causes microvascular change similar to that in occlusion of the long posterior ciliary arteries. This result suggests that the anterior ciliary artery of the rabbit contributes blood flow to the anterior eye segment and also has a stronger connection with the long posterior ciliary artery than previously reported.
Animals↗
Modification of the atrophic effects of tenotomy on mouse soleus muscles by various hind limb nerve lesions and different levels of voluntary motor activity.
The response of mouse soleus muscles to transection of the proximal tendon was examined in a variety of circumstances which might be expected to modify the amount of activation of soleus motoneurons. (i) Denervation of ankle flexors antagonistic to the soleus produced slight atrophy of intact muscles but protected soleus to some extent from the effects of concurrent tenotomy. The onset of changes in tenotomized fibers was delayed several days. (ii) Tenotomy of the soleus soon after reinnervation of the muscle fibers (following tibial nerve transection) resulted in little loss of mass and no degenerative changes. (iii) Denervation during the first few days after tenotomy halted the progress of muscle shortening and alleviated the atrophic changes at the stage reached at the time of denervation. Anesthesia without surgical intervention at the same period after tenotomy also halted the atrophic changes, despite subsequent muscle shortening. (iv) Oral administration of diazepam (approximately 1 mg/kg/day) or chlorpromazine (approximately 12 mg/kg/day), which decreased motor activity during the early posttenotomy period, reduced the amount of muscle shortening and the degree of atrophy. The results suggest that both reflex and voluntary activation of soleus motoneurons contribute to the development of atrophy after tenotomy. The response in soleus muscle seems to be particularly sensitive to the pattern of motor activity during the first 2 to 3 days after tenotomy.
Anesthesia, General↗
Differential expression of neural cell adhesion molecule (NCAM) after tenotomy in rabbit skeletal muscle.
Tenotomy is a commonly encountered event in orthopaedic surgery. In 23 rabbit extensor digitorum longus (EDL) muscles, within 24 h after tenotomy, a marked drop in maximum force production occurred. This was not explainable based on architectural changes and histological examination using standard markers for muscle injury, i.e., haematoxylin and eosin morphology, developmental myosin heavy chain (MHC) immunolabeling, and quantitation of muscle fiber type percentage, area and distribution. The expression of neural cell adhesion molecule (NCAM), a glycoprotein expressed during muscle development was measured as a function of time in these muscles. NCAM expression was increased as early as one day after tenotomy with 2.2+/-1.2% of the fibers showing positive expression. This expression level increased significantly to 15.4+/-15.2% after 7 days and then subsided to 13.2+/-10.6% 21 days after tenotomy. Two-way analysis of variance demonstrated a significant effect of time and a significant time x tenotomy method interaction. These results suggest that tenotomy leads to possible changes in muscle-nerve connections and/or excitation-contraction (EC) coupling.
Animals↗
The cosmetic appearance of the biceps muscle after long-head tenotomy versus tenodesis.
PURPOSE: This study evaluates the cosmetic appearance of the biceps muscle after arthroscopic, intra-articular biceps tenotomy versus tenodesis by presenting subjective outcome results in patients with refractive bicipital pain. TYPE OF STUDY: Retrospective study evaluating clinical follow-up of patients with refractive and chronic bicipital pain. METHODS: Five consecutive years of patients receiving biceps tenotomy (80 patients; 40 males, 40 females; average age, 58 years) or tenodesis (80 patients; 51 males, 29 females; average age, 54 years) procedures were retrospectively followed-up by grading anterior shoulder pain, muscle spasms in the biceps, and cosmetic deformity of the biceps muscle. Statistics were done by chi(2) analysis. RESULTS: When assessing the follow-up questions, no statistical significance was found between the biceps tenotomy and biceps tenodesis groups. There was also no statistical significance when comparing the biceps tenotomy and biceps tenodesis groups when evaluating only the men, women, and men versus women with respect to the questions assessed. CONCLUSIONS: In the majority of patients in which a biceps tenotomy is performed, we note that the cosmetic appearance of the biceps muscle, the grade of muscle spasms of the biceps, and the level of anterior shoulder pain would present with little difference than if a tenodesis had been performed. Therefore, a biceps tenotomy may be a reasonable alternative to a biceps tenodesis in patients with refractive and chronic bicipital pain.
Adult↗
Arthroscopic debridement of irreparable massive rotator cuff tears--a comparison of debridement alone and combined procedure with biceps tenotomy.
The goal of the study was to compare the results of arthroscopic debridement in massive, irreparable rotator cuff tears with and without tenotomy of the long head of the biceps (LHB). We evaluated 41 patients who were treated by a single surgeon for massive, irreparable rotator cuff tears either by arthroscopic debridement alone (24 patients) or with additional tenotomy of LHB (17 patients). The mean age was 67 years (range: 61 to 82 years) and the average follow-up was 31 months (range: 24 to 48 months). There was no significant difference between the two groups in age, gender, pain, function, and follow-up. All patients had significant disabling pain weakness preoperatively. Assessments were made using the Constant score. The average Constant score for the group without LHB tenotomy improved from a mean of 39 points (range: 19 to 54 points) preoperatively to a mean of 67 points (range: 41 to 87 points) and for the group with additional LHB tenotomy from a mean of 41 points (range: 16 to 54 points) preoperatively to a mean of 69 points (range: 49 to 87 points) at the time of follow-up. The radiological study showed no significant narrowing of the subacromial space. No statistical significance (P > .05) was found between the two groups. However, patients with additional LHB tenotomy had a longer duration of postoperative pain relief, but final pain score difference was not statistically significant. There was no complication related to the procedure. Arthroscopic débridement of massive, irreparable rotator cuff tears provides reliable expectation for improvement in function, decrease in pain, and improvement in shoulder scores for most patients. Additional LHB tenotomy did not significantly influence the postoperative results at the latest follow-up. In our series we noted no significant humeral head migration or developing rotator cuff arthropathy.
Aged↗
Rabbit supraspinatus tendon detachment: effects of size and time after tenotomy on morphometric changes in the muscle.
We studied the effects of size and time after rabbit supraspinatus tenotomy (group A--small tenotomy, group B--large tenotomy) on muscle morphometric changes in 48 rabbits. Animals were killed 6 (subgroups A1 and B1), 12 (subgroups A2 and B2) and 24 weeks (subgroups A3 and B3) after tendon detachment. Statistically significantly greater increases in interstitium volume were noted in subgroups A1-A3 and B1-B3 than in controls. Reductions in type I and II fiber diameters were mainly due to the length of observation. However, statistically significant differences in comparison with controls appeared earlier after large tenotomy. The size of the tenotomy primarily affected muscle fiber composition. Our results suggest that these changes were caused by fiber transformation from type I to type II and vice versa. These findings indicate that the interdigitations between the supraspinatus and infraspinatus and between the supraspinatus and subscapularis tendons are important in dynamics and the degree of morphometric changes in the rabbit supraspinatus after tenotomy.
Animals↗
Muscle shortening induced by tenotomy does not reduce activity levels in rat soleus.
1. A slow postural muscle was tenotomized to determine the role of muscle stretch on chronic recruitment patterns in freely moving animals. 2. Different amounts of muscle shortening were induced in the soleus muscles of ten rats by severing the tendon of insertion (n = 3), the whole Achilles' tendon (n = 4) or the origins and insertions (n = 3). 3. Bipolar wire electrodes were implanted on each muscle to record the electromyographic activity (EMG) under control and tenotomized conditions. The complex interference pattern was continuously analysed to determine the number and amplitude of peak potentials (called turns). The numbers of these 'turns' and their amplitudes were determined during 4 control and at least 5 experimental days. Sham-operated controls and groups matched according to the type of tenotomy were analysed for length changes and pathological changes 5 and 10 days post-tenotomy. 4. The total activity levels in all three tenotomy conditions were not significantly changed when compared with their own control levels. No differences in total activity level were found between the three tenotomized conditions. 5. The normal diurnal patterns of muscle recruitment were preserved during the tenotomized conditions, with the highest levels consistently occurring during the first 3 h of the dark cycle. 6. Tenotomy of the soleus, whether induced by distal (ST), distal and proximal (DT) or Achilles' tenotomy (AT) resulted in muscle shortening (9-26 %). No muscle pathology was found in the ST or AT groups. Degeneration was found in the DT group after 5 days, with further increases at 10 days. 7. These data suggest that the absence of stretch had no discernible influence on the aggregate activity levels in the slow postural soleus muscle. Whether tenotomy caused changes in recruitment within individual step cycles was not evaluated.
Animals↗
Differential modification of myosin heavy chain expression by tenotomy in regenerating fast and slow muscles of the rat.
We have examined the effect of tenotomy on the expression of myosin heavy chains (MyHC) in regenerating fast and slow skeletal muscles. Degeneration/regeneration of the left soleus and plantaris of Wistar male rats was induced by an injection into the muscle belly of a myotoxin (snake venom: Notechis scutatus scutatus). MyHC isoform content of regenerating plantaris and soleus muscles were studied 21 days after muscle injury using an electrophoretic technique. Tenotomy of the regenerating plantaris (mechanical underload) did not alter its MyHC expression (P > 0.05). In contrast, tenotomy of the regenerating soleus increased its relative levels of MyHC-2b (P < 0.05) and MyHC-2x/d (P < 0.01), and decreased its relative level of MyHC-1 (P < 0.01). Tenotomy of the synergistic gastrocnemius (overload) tended to decrease the relative level of MyHC-2b in regenerating plantaris (P < 0.07). The effect of tenotomy of the synergistic gastronecmius on the regenerating soleus was different: a decrease in the relative levels of MyHC-1 (P < 0.05) and an increase in the relative level of MyHC-neonatal (P < 0.01). In conclusion, and in contrast to a regenerating slow muscle, a change of mechanical loading by tenotomy did not seem to markedly alter the expression of mature MyHC phenotype in a fast regenerating muscle.
Animals↗
Effect of tenotomy on self-reinnervated and randomly reinnervated soleus muscle of rat.
The time course and degree of atrophic changes caused by tenotomy were compared in normal, self-reinnervated and randomly reinnervated soleus muscle 6 months after transsection and reunion of the nerve at different distances from the muscle. Comparison was made between the behaviour of Type I and Type II fibers, distinguished on the basis of histochemical myofibrillar ATPase and succinic dehydrogenase reactions. Cross-sectional areas of individual muscle fibers were measured using Quantimet 720 image analyser. Selective atrophy of Type I muscle fibers as determined by structural and histochemical changes was observed after tenotomy of normal, self-reinnervated and randomly reinnervated soleus muscles after transsection of the muscular branch of the tibial nerve, Type II muscle fibers in randomly reinnervated muscles were found to be relatively insensitive to tenotomy, as in normal muscle. In randomly reinnervated muscles after transsection and reunion of the sciatic nerve, tenotomy did not cause any visible structural and histochemical abnormalities although a decrease of muscle weight and cross-sectional surface area of fibers was noted. Since in these muscles Type II fibers increased to about 70% of the muscle fiber population, it is suggested that the increased percentage of Type II fibers seemed to prevent the atrophic changes in Type I fibers after tenotomy.
Animals↗
Long head biceps tenotomy versus tenodesis: a cadaveric biomechanical analysis.
PURPOSE: Treatment of pathology of the long head biceps (LHB) tendon has become an area of renewed interest among orthopaedic surgeons in recent years. Numerous authors have recommended tenotomy, whereas others have recommended tenodesis to avoid distal migration of the LHB tendon stump and the associated cosmetic deformity that may develop. The purpose of the present study was to determine the likelihood of distal migration from the bicipital groove of the long head biceps tendon after tenotomy under physiologic loading conditions and the ultimate load to failure for tenotomized LHB tendons, and to compare these values with those present after tenodesis with an interference screw in a cadaveric model. TYPE OF STUDY: Anatomic cadaveric biomechanical study. METHODS: Cyclic loading was performed on 10 cadaveric shoulders through the LHB tendon on an MTS machine (Materials Testing System; MTS Systems Corp, Minneapolis, MN) at a peak force of 50 N (loading rate of 100 N/second) for 200 cycles. After cyclic loading, the specimens were tested to failure at a loading rate of 100 N/second. Failure was defined as migration of the biceps stump distal to the bicipital groove on the proximal humerus. The LHB tendon was then passed back up the bicipital groove and tenodesis was performed in the groove with a bioabsorbable interference screw according to a previously described technique (Arthrex, Naples, FL). Cyclic and load to failure testing were then repeated in similar fashion and the values were recorded and compared with those of the tenotomized subjects (n = 10 in each group). RESULTS: Four of 10 tenotomized specimens (40%) failed during cyclic loading, with the average number of cycles to failure being 35. The other 6 specimens passed the cyclic test. The average ultimate load to failure in these specimens was 110.7 N. After biceps tenodesis, all specimens passed the cyclic loading test. The average ultimate load to failure in these 10 specimens was 310.8 N. Compared with the 6 tenotomized specimens that passed the cyclic test, the specimens that underwent tenodesis had a significantly higher pullout strength (ultimate strength) with P = .001. CONCLUSIONS: These results show that, compared with tenodesis, biceps tenotomy results in a significant risk of distal LHB tendon migration and significantly lower load to failure. Cyclic loads similar to those produced by gentle active range of motion without resistance resulted in failure in 40% of specimens tested after an average of 35 cycles. Based on these results, the authors recommend that LHB tenodesis be considered in any patient who may object to the cosmetic deformity and associated dysfunction produced by distal LHB tendon migration after tenotomy. CLINICAL RELEVANCE: The findings of this study help determine whether to perform long head biceps tenotomy or tenodesis when dealing with long head biceps tendon pathology.
Adult↗