Relationship Between Long Head of the Biceps Tendon Histopathology and Long-term Functional Results in Smokers. A Time to Reevaluate the Bonar Score?

Overview

Journal Ther Adv Chronic Dis

Publisher Sage Publications

Date 2021 Mar 12

PMID 33708369

Citations 8

Authors

Jan Zabrzynski

Maciej Gagat

Lukasz Lapaj

Lukasz Paczesny

Alper Yataganbaba

Dawid Szwedowski

Gazi Huri

Affiliations

Soon will be listed here.

Abstract

Aim: The purpose of this study was to investigate whether there is an association between smoking, the extent of the degeneration process in the biceps tendinopathy, including cells and extracellular matrix (ECM) alterations, and long-term surgical results.

Methods: This study comprised 40 consecutive patients admitted for shoulder arthroscopy due to symptomatic biceps tendinopathy and classified into three groups based on smoking status: active smokers, former smokers, and non-smokers. According to the classical Bonar score criteria, the histopathologic evaluation of the harvested intra-articular portion of the tendon was done. The follow-up examination was based on the American Shoulder and Elbow Surgeons Score (ASES).

Results: A cohort of 32 patients was enrolled in the final follow-up examination; mean 37.56 months. Histopathological evaluation according to the classical Bonar score revealed degeneration of the tendinous tissue in each group but there was no correlation between the extent of degeneration, smoking indexes and the ASES. After revision of Bonar scale within the vascularity criterion, we found a correlation between the extent of degeneration of tendinous tissue, smoking data, ASES score, and the severity of rotator cuff injury.

Conclusion: In this paper, we indicate the ambiguous role of the neovascularization in the biceps tendinopathy, and it was used for modification of the classical Bonar score. Consequently, recalculated, modified Bonar score was correlated positively with smoking indexes and functional outcomes. Furthermore, the morphological alterations of rotator cuff tendons also correlated positively with the extent of biceps tendon degeneration, measured according to the modified scoring system.

Citing Articles

Correlation between the Long Head of the Biceps Microscopic Degeneration and Extent of Apoptotic Process.

Jaworski L, Zabrzynski J, Millett P, Rupp M, Familiari F, Huri G J Clin Med. 2024; 13(15).

PMID: 39124786 PMC: 11313670. DOI: 10.3390/jcm13154520.

The Arthroscopic Biceps Rerouting Technique Shows Better Early Clinical Outcomes within 1 Year Than Partial Repair in Large to Massive Rotator Cuff Tears.

Park H, Ham K, Kim Y Medicina (Kaunas). 2024; 60(2).

PMID: 38399528 PMC: 10890027. DOI: 10.3390/medicina60020240.

The Association of Tobacco Smoking and Level of Apoptosis in the Long Head of the Biceps Chronic Tendinopathy-An Immunohistochemical Study.

Jaworski L, Zabrzynski J, Millett P, Rupp M, Familiari F, Huri G J Clin Med. 2024; 13(3).

PMID: 38337377 PMC: 10856346. DOI: 10.3390/jcm13030684.

Comparison of Outcomes between Open and Arthroscopic Rotator Cuff Repair.

Menekse S Adv Orthop. 2024; 2024:5575404.

PMID: 38249956 PMC: 10796185. DOI: 10.1155/2024/5575404.

Feasibility of Neovessel Embolization in a Large Animal Model of Tendinopathy: Safety and Efficacy of Various Embolization Agents.

Ghelfi J, Soulairol I, Stephanov O, Bacle M, de Forges H, Sanchez-Ballester N J Pers Med. 2022; 12(9).

PMID: 36143314 PMC: 9501590. DOI: 10.3390/jpm12091530.

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