Diagnostic value of the hourglass biceps test for the detection of intra-articular long head of the biceps hypertrophy
Background: Shoulder surgeons performing tenodesis note a great variability in morphology of the proximal biceps. The hourglass biceps test measures the integrity of the intra-articular biceps tendon. The hourglass maneuver (HM) is positive when there is a passive flexion deficit compared to the con...
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doaj-4a3805b92daf4951907b7712b45c80ce2021-03-22T08:45:14ZengElsevierJSES International2666-63832020-12-0144906912Diagnostic value of the hourglass biceps test for the detection of intra-articular long head of the biceps hypertrophyQuentin Baumann, MD0Antoine-Guy Hue, MD1Patricia Maria Lutz, MD2Alexandre Hardy, MD3Patrice Mertl, MD, PhD4Olivier Courage, MD5Université Paris Diderot, Bichat Hospital, service d'orthopédie, Paris, France; Hôpital Privé de l'Estuaire, Ramsay General Health Group, Le Havre, France; Corresponding author: Quentin Baumann, MD, Université Paris Diderot, Bichat Hospital, service d'orthopédie, Paris, France.Hôpital Privé de l'Estuaire, Ramsay General Health Group, Le Havre, France; CHU de Rouen (Rouen) Département d'Orthopédie, Traumatologie, Rouen, FranceDepartment of Orthopaedic Sports Medicine, Technical University, Munich, GermanyClinique du Sport, Paris, FranceCHU Amiens, Amiens, FranceCHU de Rouen (Rouen) Département d'Orthopédie, Traumatologie, Rouen, FranceBackground: Shoulder surgeons performing tenodesis note a great variability in morphology of the proximal biceps. The hourglass biceps test measures the integrity of the intra-articular biceps tendon. The hourglass maneuver (HM) is positive when there is a passive flexion deficit compared to the contralateral shoulder in a relaxed patient in the supine position. Hypothesis: Preoperative HM is correlated with an increased width of the biceps portion resected during tenodesis. Methods: This prospective study evaluated all patients (N = 58) who underwent biceps tenodesis between January and September 2019. Two groups of patients were compared: group 1 (n = 20) had a positive HM and group 2 had a negative HM (n = 38). The smallest (s) and largest (L) width of the tendon were measured intraoperatively, and the L/s ratio was calculated. The HM was then evaluated as a diagnostic test by creating a contingency table and determining the sensitivity and specificity of the test for different L/s ratios. A receiver operating characteristic curve was created and the area under the curve (AUC) was calculated. Results: A nonsignificant difference was found between the mean largest biceps width in group 1 compared to group 2 (11.65 mm [range: 5-21] vs. 9.71 mm [range: 6-20], respectively; P < .05). The AUC was 0.81; the sensitivity was 68.9% and specificity, 80.8%. Conclusion: Preoperative positivity of the HM is linked to the increased width of the biceps portion resected during tenodesis. The hourglass biceps test should be predictive of intraoperative hourglass biceps according to our definition.http://www.sciencedirect.com/science/article/pii/S2666638320300876Tenodesisbicepshourglassarthroscopytenotomybicipital groove |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Quentin Baumann, MD Antoine-Guy Hue, MD Patricia Maria Lutz, MD Alexandre Hardy, MD Patrice Mertl, MD, PhD Olivier Courage, MD |
spellingShingle |
Quentin Baumann, MD Antoine-Guy Hue, MD Patricia Maria Lutz, MD Alexandre Hardy, MD Patrice Mertl, MD, PhD Olivier Courage, MD Diagnostic value of the hourglass biceps test for the detection of intra-articular long head of the biceps hypertrophy JSES International Tenodesis biceps hourglass arthroscopy tenotomy bicipital groove |
author_facet |
Quentin Baumann, MD Antoine-Guy Hue, MD Patricia Maria Lutz, MD Alexandre Hardy, MD Patrice Mertl, MD, PhD Olivier Courage, MD |
author_sort |
Quentin Baumann, MD |
title |
Diagnostic value of the hourglass biceps test for the detection of intra-articular long head of the biceps hypertrophy |
title_short |
Diagnostic value of the hourglass biceps test for the detection of intra-articular long head of the biceps hypertrophy |
title_full |
Diagnostic value of the hourglass biceps test for the detection of intra-articular long head of the biceps hypertrophy |
title_fullStr |
Diagnostic value of the hourglass biceps test for the detection of intra-articular long head of the biceps hypertrophy |
title_full_unstemmed |
Diagnostic value of the hourglass biceps test for the detection of intra-articular long head of the biceps hypertrophy |
title_sort |
diagnostic value of the hourglass biceps test for the detection of intra-articular long head of the biceps hypertrophy |
publisher |
Elsevier |
series |
JSES International |
issn |
2666-6383 |
publishDate |
2020-12-01 |
description |
Background: Shoulder surgeons performing tenodesis note a great variability in morphology of the proximal biceps. The hourglass biceps test measures the integrity of the intra-articular biceps tendon. The hourglass maneuver (HM) is positive when there is a passive flexion deficit compared to the contralateral shoulder in a relaxed patient in the supine position. Hypothesis: Preoperative HM is correlated with an increased width of the biceps portion resected during tenodesis. Methods: This prospective study evaluated all patients (N = 58) who underwent biceps tenodesis between January and September 2019. Two groups of patients were compared: group 1 (n = 20) had a positive HM and group 2 had a negative HM (n = 38). The smallest (s) and largest (L) width of the tendon were measured intraoperatively, and the L/s ratio was calculated. The HM was then evaluated as a diagnostic test by creating a contingency table and determining the sensitivity and specificity of the test for different L/s ratios. A receiver operating characteristic curve was created and the area under the curve (AUC) was calculated. Results: A nonsignificant difference was found between the mean largest biceps width in group 1 compared to group 2 (11.65 mm [range: 5-21] vs. 9.71 mm [range: 6-20], respectively; P < .05). The AUC was 0.81; the sensitivity was 68.9% and specificity, 80.8%. Conclusion: Preoperative positivity of the HM is linked to the increased width of the biceps portion resected during tenodesis. The hourglass biceps test should be predictive of intraoperative hourglass biceps according to our definition. |
topic |
Tenodesis biceps hourglass arthroscopy tenotomy bicipital groove |
url |
http://www.sciencedirect.com/science/article/pii/S2666638320300876 |
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