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Ultrasound-Guided Suprapectoral Tenodesis of the Long Head of the Biceps Brachii.

ABSTRACT: When the long head of the biceps tendon is diseased, tenodesis is an appropriate treatment strategy. The specific technique used is dependent on visualization, fixation method and hardware, and tenodesis location. For suprapectoral tenodesis techniques, those that fix the tendon within or below the bicipital groove can be challenging owing to the transverse humeral ligament covering the groove. To accurately identify the biceps tendon in this area, the ligament often requires resection. Ultrasound provides surgeons with a safe and noninvasive tool to visualize the biceps tendon as it exits the bicipital groove, negating the need for unroofing and other pitfalls associated with traditional techniques. This technical note describes an ultrasound-guided suprapectoral biceps tenodesis procedure.

SUBMITTER: Andersen WJ

PROVIDER: S-EPMC7768307 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Tenoscopic Suprapectoral Biceps Tenodesis.

Project description:Existing arthroscopic techniques of proximal biceps tenodesis may be complicated by difficulty of tendon identification, restoration of length-tension relation, cosmetic deformity, persistent biceps pain, and shoulder stiffness requiring surgical revision in a relevant proportion of cases. In this context, biceps tenoscopy, an emerging discipline of shoulder endoscopy, offers major benefits. Tenoscopy comprises endoscopic treatment of tendons and tendon sheaths. The presented technique of tenoscopic suprapectoral biceps tenodesis (TSBT) substantially facilitates tendon identification and reduces invasiveness by avoidance of unnecessary surgical involvement of the deltoid space and bursa. TSBT enables effective treatment of the biceps tendon and surrounding tissues (biceps tendon sheath, tenosynovium, transverse humeral ligament) being consistently involved in proximal biceps pathologies. The physiological length-tension relation of the musculotendinous unit is reliably maintained. Technically, the procedure of tenodesis is simplified and accelerated by redundancy of tendon exteriorization. The aforementioned benefits of TSBT may lead to superior clinical and cosmetic outcomes and lower incidences of persistent proximal biceps pain and postoperative shoulder stiffness compared with conventional techniques of arthroscopic biceps tenodesis.

| S-EPMC4810757 | biostudies-literature

Arthroscopic Suprapectoral Biceps Tenodesis With Tenodesis Screw.

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Arthroscopic suprapectoral tenodesis of the long head biceps: reproducing an anatomic length-tension relationship.

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| S-EPMC3678639 | biostudies-literature

Technique of Arthroscopic Suprapectoral Tenodesis of the Long Head of the Biceps With Interference Screw.

Project description:Tenodesis and tenotomy are the main surgical options to treat different pathologies of the long head of the biceps tendon. Maintaining the functionality of the tendon during tenodesis makes it more preferable surgical option. The consensus on the most advanced tenodesis technique has not been reached. The article presents the arthroscopic all-inside technique of suprapectoral tenodesis of the biceps tendon using the technique of "zone marking" with 2 spinal needles or pins.

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All-Arthroscopic Suprapectoral Biceps Tenodesis.

Project description:Biceps tenodesis is a common treatment for pathology of the long head of the biceps tendon. Several authors have described various arthroscopic and open techniques for biceps tenodesis. Open techniques have been associated with complications such as wound infection and nerve injury. Previously described arthroscopic techniques have placed the tenodesis site within the bicipital groove, which may lead to persistent pain. We describe an all-arthroscopic suprapectoral biceps tenodesis technique that places the tenodesis site distal to the bicipital groove. This technique potentially avoids the complications associated with open tenodesis surgery while still removing the biceps tendon from the bicipital groove.

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Transosseous Suture-Based Arthroscopic Suprapectoral Biceps Tenodesis.

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Arthroscopic Suprapectoral Biceps Tenodesis Using Standard Portals

Project description:The long head of the biceps (LHB) tendon is a common cause of shoulder pain. Biceps tenodesis is commonly used to address biceps and superior labrum pathology, reducing pain and restoring function. There are numerous techniques for biceps tenodesis, and it is unclear as to which single technique and approach provides significantly superior outcomes. In this technical note, we present an arthroscopic suprapectoral approach with release of the LHB from the bicipital groove and subsequent fixation with suture anchor. This technique simplifies the technique to be performed from standard arthroscopic portals and aims to maximize outcomes and minimize common complications associated with biceps tenodesis. Technique Video Video 1 The video for an arthroscopic suprapectoral biceps tenodesis technique viewing through the posterior portal using standard arthroscopic portals of a left shoulder with the patient positioned in a beach chair position.

| S-EPMC10466255 | biostudies-literature

Lateral Decubitus Position for Arthroscopic Suprapectoral Biceps Tenodesis.

Project description:The purpose of this report is to describe arthroscopic suprapectoral biceps tenodesis in the lateral decubitus position. Many technique descriptions for this procedure emphasize the beach-chair position to obtain optimal anterior subdeltoid visualization of the relevant anatomy. This is not required and may be less desirable or comfortable for a shoulder arthroscopist who prefers the lateral decubitus position. Therefore, the aim of this report is to show that the relevant anatomy may be readily and safely accessed, and the procedure effectively performed, in the lateral decubitus position.

| S-EPMC7093707 | biostudies-literature

Increased Risk of Humeral Fracture With Open Versus Arthroscopic Tenodesis of the Long Head of the Biceps Brachii.

Project description:PurposeTo determine the risk of postoperative humeral fracture following tenotomy, open tenodesis and arthroscopic tenodesis of the long head of the biceps brachii.MethodsA retrospective review of deidentified patient data from the Medicare Standard Analytic File using the PearlDiver software was conducted to identify procedures performed between 2005 and 2014. Groups were matched by age, gender, region, and medical comorbidities.ResultsWe evaluated 157,163 patients who had undergone arthroscopic or open tenodesis or tenotomy of the long head of the biceps brachii over a 10-year period (2005-2014), and we identified 2,196 postoperative humeral fractures (1.4%). Matched subgroup analysis consisting of 44,292 patients demonstrated a statistically significant increase in humeral fracture risk in open (280; 1.26%) compared to arthroscopic tenodesis (232; 1.04%) with a P value of 0.03 and an odds ratio of 1.21. The majority of fractures were sustained by patients 65-74 years of age.ConclusionIn this study, an increased risk of postoperative humeral fracture was associated with open tenodesis of the LHB.Level of evidenceIII, Retrospective Comparative Trial.

| S-EPMC7451862 | biostudies-literature

An All-Arthroscopic, Length-Tensioned Suprapectoral Biceps Tenodesis Technique.

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| S-EPMC5709792 | biostudies-literature

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