RESUMO

Objective: The main objective was to evaluate the anterior flexion force (AFF) and the lateral abduction force (LAF) of patients who underwent reverse shoulder arthroplasty (RSA) and to compare the measured force with that in a similar-age control group. The secondary objective was to identify prognostic factors for muscle strength recovery. Methods: Forty-two shoulders that underwent primary RSA between September 2009 and April 2020 met the inclusion criteria and were called the arthroplasty group (AG). The control group (CG) consisted of 36 patients. The mean AFF and the mean LAF were evaluated with a digital isokinetic traction dynamometer. Results: The average AFF found in the AG was 15 N, while in the CG, the average AFF was 21 N (P < .001). The average LAF in the AG was 14 N (standard deviation [SD] 8 N), while in the CG the average LAF was of 19 N (SD 6 N) (P = .002). All prognostic factors studied in the AG showed no statistical significance: dominance (AFF 0.697/LAF 0.883), previous rotator cuff repair surgery (AFF 0.786/LAF 0.821), Hamada radiological classification (AFF 0.343/LAF 0.857), magnetic resonance imaging (MRI) pre-operative evaluation of the quality of the teres minor (AFF 0.131/LAF 0.229), suture of the subscapularis at the end of the arthroplasty procedure (AFF 0.961/LAF 0.325) and postoperative complications (AFF 0.600/LAF 0.960). Conclusion: The mean AFF was 15 N, and the mean LAF was 14 N. The comparison of AFF and LAF with a CG showed a 25% reduction in muscle strength. It was not possible to demonstrate prognostic factors for muscle strength recovery after RSA.

RESUMO

OBJECTIVE: To evaluate whether body mass index (BMI) 30 can be used as a cut-off point in decisions about whether or not to perform long head biceps (LHB) tenodesis, leading to a low rate of esthetic complaints, and to compare two tenodesis techniques. METHODS: Ninety-six patients underwent shoulder arthroscopy where tenotomy was performed separately in patients with a BMI ≥30 and was followed by tenodesis when BMI <30. The patients were assessed on the basis of their personal perception of the deformity and by 3 independent observers. RESULTS: The patient's perception of esthetic deformity in the arm was 15.6%. In the tenotomy group (12.5%) and in the tenodesis group (17.9%) - (p = 0.476). Patients with rocambole-like tenodesis perceived the deformity in 13.2% of cases, while patients with anchor tenodesis noticed the deformity 27.8% (p = 0.263) of the time. There was no statistical difference in the perception of deformity among the independent examiners. CONCLUSION: BMI 30 can be used as a cut-off point in decisions about whether or not to perform LHB tenodesis, leading to low rates of esthetic complaint by patients (12.5%). The rocambole-like tenodesis technique appears to be more able to avoid esthetic deformity of the arm after the LHB tenotomy according to the patients' observations. Level of evidence II, Prospective comparative study.

OBJETIVO: Avaliar se índice de massa corporal (IMC) 30 pode ser utilizado como ponto de corte nas decisões sobre realizar ou não a tenodese da cabeça longa do bíceps (CLB), levando a um baixo índice de queixa estética, e comparar duas técnicas de tenodese. MÉTODOS: Foram submetidos à cirurgia artroscópica no ombro 96 pacientes, sendo a tenotomia realizada de forma isolada nos pacientes com IMC ≥ 30 e seguida de tenodese quando IMC < 30. Os pacientes foram avaliados por sua percepção pessoal da deformidade e por três observadores independentes. RESULTADOS: A percepção da deformidade estética no braço pelo paciente foi de 15,6%. No grupo tenotomia (12,5%) e no grupo tenodese (17,9%) - (p=0,476). Pacientes com tenodese rocambole perceberam a deformidade em 13,2% dos casos, enquanto os pacientes com tenodese em âncora a notaram em 27,8% das vezes (p=0,263). Não houve diferença estatística para a percepção da deformidade entre os examinadores independentes. CONCLUSÃO: IMC 30 pode ser usado como ponto de corte nas decisões sobre realizar ou não a tenodese da CLB, levando a baixos índices de queixa estética por parte dos pacientes (12,5%). A técnica de tenodese tipo rocambole parece ter mais capacidade de evitar a deformidade estética do braço após a tenotomia da CLB, conforme a observação dos pacientes (13,2%). Nível de evidência II, estudo prospectivo comparativo.

RESUMO

ABSTRACT Objective: To evaluate whether body mass index (BMI) 30 can be used as a cut-off point in decisions about whether or not to perform long head biceps (LHB) tenodesis, leading to a low rate of esthetic complaints, and to compare two tenodesis techniques. Methods: Ninety-six patients underwent shoulder arthroscopy where tenotomy was performed separately in patients with a BMI ≥30 and was followed by tenodesis when BMI <30. The patients were assessed on the basis of their personal perception of the deformity and by 3 independent observers. Results: The patient's perception of esthetic deformity in the arm was 15.6%. In the tenotomy group (12.5%) and in the tenodesis group (17.9%) - (p = 0.476). Patients with rocambole-like tenodesis perceived the deformity in 13.2% of cases, while patients with anchor tenodesis noticed the deformity 27.8% (p = 0.263) of the time. There was no statistical difference in the perception of deformity among the independent examiners. Conclusion: BMI 30 can be used as a cut-off point in decisions about whether or not to perform LHB tenodesis, leading to low rates of esthetic complaint by patients (12.5%). The rocambole-like tenodesis technique appears to be more able to avoid esthetic deformity of the arm after the LHB tenotomy according to the patients' observations. Level of evidence II, Prospective comparative study.

RESUMO Objetivo: Avaliar se índice de massa corporal (IMC) 30 pode ser utilizado como ponto de corte nas decisões sobre realizar ou não a tenodese da cabeça longa do bíceps (CLB), levando a um baixo índice de queixa estética, e comparar duas técnicas de tenodese. Métodos: Foram submetidos à cirurgia artroscópica no ombro 96 pacientes, sendo a tenotomia realizada de forma isolada nos pacientes com IMC ≥ 30 e seguida de tenodese quando IMC < 30. Os pacientes foram avaliados por sua percepção pessoal da deformidade e por três observadores independentes. Resultados: A percepção da deformidade estética no braço pelo paciente foi de 15,6%. No grupo tenotomia (12,5%) e no grupo tenodese (17,9%) - (p=0,476). Pacientes com tenodese rocambole perceberam a deformidade em 13,2% dos casos, enquanto os pacientes com tenodese em âncora a notaram em 27,8% das vezes (p=0,263). Não houve diferença estatística para a percepção da deformidade entre os examinadores independentes. Conclusão: IMC 30 pode ser usado como ponto de corte nas decisões sobre realizar ou não a tenodese da CLB, levando a baixos índices de queixa estética por parte dos pacientes (12,5%). A técnica de tenodese tipo rocambole parece ter mais capacidade de evitar a deformidade estética do braço após a tenotomia da CLB, conforme a observação dos pacientes (13,2%). Nível de evidência II, estudo prospectivo comparativo.