{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T23:22:53Z","timestamp":1781911373692,"version":"3.54.5"},"reference-count":35,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T00:00:00Z","timestamp":1677110400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T00:00:00Z","timestamp":1677110400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T00:00:00Z","timestamp":1677110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005713","name":"Technische Universit\u00e4t M\u00fcnchen","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005713","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100005713","name":"Technische Universit\u00e4t M\u00fcnchen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005713","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To investigate the influence of intertubercular groove (IG) morphology on the development of different types of biceps reflection pulley (BRP) injuries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A consecutive cohort of 221 patients with ventral shoulder pain and a preoperative diagnosis suspecting BRP injury, who underwent arthroscopy, was retrospectively reviewed. The presence or absence as well as type of pulley injury (medial, lateral or bilateral) was confirmed arthroscopically. The intertubercular groove was evaluated on MRIs after triplanar reconstruction of the axial plane. IG depth, width, medial wall angle (MWA), lateral wall angle (LWA) and total opening angle (TOA) were measured. IG depth and width were expressed in relation to the humeral head diameter. Measurements were performed by two clinicians independently and averaged.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 166\u00a0included patients 43 had bilateral, 65\u00a0medial and 38 lateral BRP lesions. 20 patients had intact BRPs and represented the control group.<\/jats:p><jats:p>The intra\u2010class correlation coefficient of measurements was 0.843\u20130.955. Patients with a medial or bilateral BRP injury had a flatter MWA (38.8\u00b0 or 40.0\u00b0 vs. 47.9\u00b0, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), wider TOA (96.1\u00b0 or 96.6\u00b0 vs. 82.6\u00b0, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), greater width (12.5 or 12.3 vs. 10.8\u00a0mm, <jats:italic>p<\/jats:italic>\u2009=\u20090.013) and shallower depth (5.5 or 5.4 vs. 6.2\u00a0mm, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) than the control group. Conversely, the IG morphology of those with lateral BRP injuries did not differ significantly from the control group. The odds ratio for a medial or bilateral BRP injury when the TOA exceeded 95\u00b0 was 6.8 (95% confidence interval 3.04\u201315.2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A dysplastic type of IG morphology with a wide TOA, flat MWA, decreased depth and increased width is associated with the presence of medial and bilateral BRP injuries. A TOA of\u2009&gt;\u200995\u00b0 increases the likelihood of a medial or bilateral BRP injury 6.8\u2010fold. Lateral BRP injuries are not associated with dysplastic IG morphology. Concomitant LHBT surgery may, therefore, not always be necessary during isolated supraspinatus tendon repair.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Level III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-023-07350-x","type":"journal-article","created":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T07:02:41Z","timestamp":1677135761000},"page":"3221-3229","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A shallow morphology of the intertubercular groove is associated with medial and bilateral but not lateral pulley lesions"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9765-5091","authenticated-orcid":false,"given":"Benjamin Daniel","family":"Kleim","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Sports Orthopedics Technical University of Munich Ismaninger Str. 22 81675 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose Fernando Sanchez","family":"Carbonel","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Sports Orthopedics Technical University of Munich Ismaninger Str. 22 81675 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Hinz","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Sports Orthopedics Technical University of Munich Ismaninger Str. 22 81675 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco\u2010Christopher","family":"Rupp","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Sports Orthopedics Technical University of Munich Ismaninger Str. 22 81675 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bastian","family":"Scheiderer","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Sports Orthopedics Technical University of Munich Ismaninger Str. 22 81675 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas Balthasar","family":"Imhoff","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Sports Orthopedics Technical University of Munich Ismaninger Str. 22 81675 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Siebenlist","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Sports Orthopedics Technical University of Munich Ismaninger Str. 22 81675 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,2,23]]},"reference":[{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2010.04.044"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.89B8.19278"},{"key":"e_1_2_10_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018\u2010021\u201002621\u20100"},{"key":"e_1_2_10_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2007.04.011"},{"key":"e_1_2_10_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0749\u20108063(98)70012\u2010X"},{"key":"e_1_2_10_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1058\u20102746(05)80034\u20105"},{"key":"e_1_2_10_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546509355142"},{"key":"e_1_2_10_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40634\u2010022\u201000550\u20103"},{"key":"e_1_2_10_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2018.06.012"},{"key":"e_1_2_10_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00256\u2010022\u201004056\u2010y"},{"key":"e_1_2_10_12_2","doi-asserted-by":"publisher","DOI":"10.1123\/jsr.2015\u20100055"},{"key":"e_1_2_10_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2003.09.013"},{"key":"e_1_2_10_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402\u2010017\u20102721\u2010z"},{"key":"e_1_2_10_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2021.10.028"},{"key":"e_1_2_10_16_2","doi-asserted-by":"publisher","DOI":"10.1067\/mse.2000.106746"},{"key":"e_1_2_10_17_2","first-page":"293","article-title":"Effects of bicipital groove bony morphology on the stability of long head of the biceps tendon","volume":"3","author":"Kavak RP","year":"2019","journal-title":"Eurasian J Med Investigation"},{"key":"e_1_2_10_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.asmr.2021.04.006"},{"key":"e_1_2_10_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2006.08.025"},{"key":"e_1_2_10_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00191083"},{"key":"e_1_2_10_21_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.F.01012"},{"key":"e_1_2_10_22_2","doi-asserted-by":"publisher","DOI":"10.1186\/s10195\u2010019\u20100531\u20105"},{"key":"e_1_2_10_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.csm.2015.08.003"},{"key":"e_1_2_10_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jseint.2020.02.011"},{"key":"e_1_2_10_25_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465221085661"},{"key":"e_1_2_10_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jseint.2022.06.003"},{"key":"e_1_2_10_27_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.12112007"},{"key":"e_1_2_10_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2021.12.014"},{"key":"e_1_2_10_29_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402\u2010021\u201003760\u2010z"},{"key":"e_1_2_10_30_2","unstructured":"VaracalloM MairSD.Proximal Biceps Tendinitis and Tendinopathy.StatPearls. Treasure Island (FL): StatPearls Publishing"},{"key":"e_1_2_10_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.csm.2015.08.010"},{"key":"e_1_2_10_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1058\u20102746(98)90218\u2010X"},{"key":"e_1_2_10_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1058\u20102746(09)80020\u20107"},{"key":"e_1_2_10_34_2","unstructured":"WhiteMH.How big should the control group be in a randomized field experiment?2018;https:\/\/www.markhw.com\/blog\/control\u2010size. Accessed 20 Aug. 2018."},{"key":"e_1_2_10_35_2","doi-asserted-by":"publisher","DOI":"10.1177\/2309499017717195"},{"key":"e_1_2_10_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2021.05.010"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-023-07350-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00167-023-07350-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-023-07350-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00167-023-07350-x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T14:19:12Z","timestamp":1760883552000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1007\/s00167-023-07350-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,23]]},"references-count":35,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1007\/s00167-023-07350-x"],"URL":"https:\/\/doi.org\/10.1007\/s00167-023-07350-x","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,23]]},"assertion":[{"value":"10 October 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 February 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 February 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"No conflict of interest pertaining to the subject of this manuscript is declared by any of the authors.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Ethical approval was granted by the ethics committee of the medical faculty of the technical university of Munich prior to study commencement, reference: 359\/20 S-EB. As permitted by the approval of the ethics committee (above), no informed consent was required for this retrospective study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}