scholarly journals Use of Novel Radiofrequency Wand for the Application of the Biceps Tenotomy and Subacromonical Bursectomy

2021 ◽  
Author(s):  
Nirav H. Amin ◽  
Joseph N. Liu
Keyword(s):  
Biceps Tenotomy

scholarly journals SLAP Tears

2021 ◽  
Vol 1 (3) ◽  
pp. 263502542110007
Author(s):  
Steven B. Cohen ◽  
John R. Matthews
Keyword(s):  
Rotator Cuff ◽  
Shoulder Arthroscopy ◽  
Biceps Tendon ◽  
Full Range ◽  
Contralateral Side ◽  
Highly Active ◽  
Slap Repair ◽  
Biceps Tenotomy ◽  
Labral Tears ◽  
Anterior Posterior

Background: Superior labral tears are frequently encountered during shoulder arthroscopy. Outcomes following superior labral anterior-posterior (SLAP) repairs in young athletes have been well documented. Superior labral repairs in older patient population continue to remain controversial due to concerns of postoperative complications including persistent preoperative symptoms, pain, stiffness, and higher rates of revision surgery. Indications: We present a case of a highly active 38-year-old woman who failed 1½ years of nonoperative management of a type IIB SLAP tear with extension to the posterior labrum. Her symptoms continued to limit her hobbies and work. Technique: A knotless single-anchor SLAP repair was performed along with debridement of the posterior frayed labrum. No biceps tenotomy or tenodesis was performed after full evaluation of the tendon failed to demonstrate evidence of synovitis, tendinopathy, or tear. The patient also did not have any concomitant shoulder pathology, including a rotator cuff tear or chondral lesion. Results: At 6 months, the patient had regained full range of motion similar to the contralateral side. She had returned to her normal activities and sports, including tennis. Discussion/Conclusion: Successful outcomes following SLAP repairs in patients over 35 years can be achieved, but treatment should be individualized with particular attention to concomitant pathology involving the rotator cuff, chondral surface, or biceps tendon which may require tenodesis or tenotomy.

scholarly journals Measurements of Tendon Movement Within the Bicipital Groove After Suprapectoral Intra-articular Biceps Tenodesis in a Cadaveric Model

2021 ◽  
Vol 9 (1) ◽  
pp. 232596712097753
Author(s):  
Brian J. Kelly ◽  
Alan W. Reynolds ◽  
Patrick J. Schimoler ◽  
Alexander Kharlamov ◽  
Mark Carl Miller ◽  
...  
Keyword(s):  
Biceps Tendon ◽  
Full Range ◽  
Elbow Flexion ◽  
Biceps Tenodesis ◽  
Bicipital Groove ◽  
Biceps Tenotomy ◽  
Flexion Extension ◽  
Before And After ◽  
Long Head ◽  
Scapular Motion

Background: Lesions of the long head of the biceps can be successfully treated with biceps tenotomy or tenodesis when surgical management is elected. The advantage of a tenodesis is that it prevents the potential development of a cosmetic deformity or cramping muscle pain. Proponents of a subpectoral tenodesis believe that “groove pain” may remain a problem after suprapectoral tenodesis as a result of persistent motion of the tendon within the bicipital groove. Purpose/Hypothesis: To evaluate the motion of the biceps tendon within the bicipital groove before and after a suprapectoral intra-articular tenodesis. The hypothesis was that there would be minimal to no motion of the biceps tendon within the bicipital groove after tenodesis. Study Design: Controlled laboratory study. Methods: Six fresh-frozen cadaveric arms were dissected to expose the long head of the biceps tendon as well as the bicipital groove. Inclinometers and fiducials (optical markers) were used to measure the motions of the scapula, forearm, and biceps tendon through a full range of shoulder and elbow motions. A suprapectoral biceps tenodesis was then performed, and the motions were repeated. The motion of the biceps tendon was quantified as a function of scapular or forearm motion in each plane, both before and after the tenodesis. Results: There was minimal motion of the native biceps tendon during elbow flexion and extension but significant motion during all planes of scapular motion before tenodesis, with the most motion occurring during shoulder flexion-extension (20.73 ± 8.21 mm). The motion of the biceps tendon after tenodesis was significantly reduced during every plane of scapular motion compared with the native state ( P < .01 in all planes of motion), with a maximum motion of only 1.57 mm. Conclusion: There was a statistically significant reduction in motion of the biceps tendon in all planes of scapular motion after the intra-articular biceps tenodesis. The motion of the biceps tendon within the bicipital groove was essentially eliminated after the suprapectoral biceps tenodesis. Clinical Relevance: This arthroscopic suprapectoral tenodesis technique can significantly reduce motion of the biceps tendon within the groove in this cadaveric study, possibly reducing the likelihood of groove pain in the clinical setting.

scholarly journals Wide-Awake Shoulder Nanoscopic Long Head of Biceps Tenotomy

2021 ◽  
Vol 10 (3) ◽  
pp. e909-e912
Author(s):  
Chris Peach ◽  
Ronnie Davies ◽  
Nick Phillips
Keyword(s):  
Long Head Of Biceps ◽  
Biceps Tenotomy ◽  
Long Head ◽  
Wide Awake

scholarly journals In-Office Biceps Tenotomy with Needle Arthroscopy: A Feasibility Study

2021 ◽  
Author(s):  
Marc-Olivier Gauci ◽  
Brieuc Monin ◽  
Alexandre Rudel ◽  
Laurent Blasco ◽  
Bastien Bige ◽  
...  
Keyword(s):  
Feasibility Study ◽  
Biceps Tenotomy

Biceps tenotomy versus soft-tissue tenodesis in females aged 60 years and older with rotator cuff tears

2021 ◽  
Author(s):  
Itaru Kawashima ◽  
Shinya Ishizuka ◽  
Hideki Hiraiwa ◽  
Shiro Imagama ◽  
Norimasa Takahashi ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Rotator Cuff ◽  
Rotator Cuff Tears ◽  
Biceps Tenotomy

scholarly journals Biceps Detachment Preserves Joint Function in a Chronic Massive Rotator Cuff Tear Rat Model

2018 ◽  
Vol 46 (14) ◽  
pp. 3486-3494 ◽  
Author(s):  
Mengcun Chen ◽  
Snehal S. Shetye ◽  
Julianne Huegel ◽  
Corinne N. Riggin ◽  
Daniel J. Gittings ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Joint ◽  
Shoulder Function ◽  
Rotator Cuff Tears ◽  
Subscapularis Tendon ◽  
Joint Function ◽  
Massive Rotator Cuff Tears ◽  
Sham Surgery ◽  
Biceps Tenotomy

Background: Lesions of the long head of the biceps tendon are often associated with massive rotator cuff tears (MRCTs), and biceps tenotomy is frequently performed for pain relief and functional reservation. However, the efficacy and safety of biceps tenotomy regarding the effects on the surrounding tissues in chronic MRCT are unclear. Hypothesis: Biceps tenotomy would result in improved mechanical and histological properties of the intact subscapularis tendon and improved in vivo shoulder function while not compromising glenoid cartilage properties. Study Design: Controlled laboratory study. Methods: Right supraspinatus and infraspinatus tendons were detached in 25 male Sprague-Dawley rats, followed by 4 weeks of cage activity to create a chronic MRCT condition. Animals were randomly divided into 2 groups and received either biceps tenotomy (n = 11) or sham surgery (n = 14) and were sacrificed 4 weeks thereafter. Forelimb gait and ground-reaction forces were recorded 1 day before the tendon detachment (baseline), 1 day before the surgical intervention (biceps tenotomy or sham), and 3, 7, 10, 14, 21, and 28 days after the intervention to assess in vivo shoulder joint function. The subscapularis tendon and glenoid cartilage were randomly allocated for mechanical testing or histologic assessment after the sacrifice. Results: Compared with sham surgery, biceps tenotomy partially restored the in vivo shoulder joint function, with several gait and ground-reaction force parameters returning closer to preinjury baseline values at 4 weeks. With biceps tenotomy, mechanical properties of the subscapularis tendons were improved, while mechanical properties and histological Mankin scores of the glenoid cartilage were not diminished when compared with the sham group. Conclusion: Biceps tenotomy in the presence of chronic MRCT partially preserves overall shoulder function and potentially restores subscapularis tendon health without causing detrimental effects to joint cartilage. This laboratory study adds to the growing literature regarding the protective effects of biceps tenotomy on the shoulder joint in a chronic MRCT model. Clinical Relevance: This study provides important basic science evidence supporting the use of biceps tenotomy in patients with massive rotator cuff tears.

scholarly journals Technique description: Incisionless ultrasound-assisted biceps tenotomy in dogs

2021 ◽  
Vol 10 (4) ◽  
pp. 457-464
Author(s):  
David Lane ◽  
Teresa Schiller
Keyword(s):  
Ultrasound Imaging ◽  
Invasive Technique ◽  
Hypodermic Needle ◽  
Surgical Incision ◽  
Percutaneous Approach ◽  
Complete Transection ◽  
Biceps Tenotomy ◽  
Iatrogenic Damage ◽  
Scalpel Blade ◽  
Open Arthrotomy

Background: Bicipital tendinitis and/or tendinopathy is a common cause of forelimb lameness in dogs, particularly in larger and more active patients. Although conservative treatment aimed at resolving discomfort and preserving the tendon remains the primary therapeutic goal, in certain cases it is necessary to surgically transect the tendon to eliminate pain and lameness. Transection of the tendon can be performed by open arthrotomy, arthroscopically, or percutaneously using a scalpel blade. This paper examines the utility of a modified percutaneous approach using ahypodermic needle in place of a scalpel blade, under ultrasound-guided assistance.Aim: To develop and describe a surgical technique for performing a percutaneous biceps tenotomy using a hypodermic needle under ultrasound guidance Method: The technique was piloted using the shoulders of 12 cadaver dogs initially and once developed, then applied to another 12 cadavers. The final procedure was performed on a total of 22 shoulders. Assessments were recorded on time to complete the procedure, completeness of bicipital tendon transection, and presence of any iatrogenic damage to associated joint structures. Results: Procedure time averaged fewer than 2 minutes. Complete transection was achieved in 20 out of 22 of the shoulders, with evidence of incomplete transection discernable by ultrasound imaging in the remaining two shoulders. One cadaver shoulder experienced iatrogenic damage secondary to incorrect hypodermic needle angulation. Conclusion: Percutaneous biceps tenotomy using a hypodermic needle is an efficient and straightforward procedure. The lack of a surgical incision makes it the least invasive technique devised so far. Ultrasound imaging allows thepractitioner to assess the completeness of the transection increasing precision.

Cadaveric evaluation of canine arthroscopic bicipital tenotomy

2002 ◽  
Vol 15 (04) ◽  
pp. 215-222 ◽  
Author(s):  
K. S. Schulz ◽  
K. Ingel ◽  
I. G. Holsworth
Keyword(s):  
Elbow Flexion ◽  
Tendon Sheath ◽  
Anatomical Location ◽  
Anatomical Dissection ◽  
Tendon Length ◽  
Camera Port ◽  
Shoulder Joints ◽  
Biceps Tenotomy ◽  
Thoracic Limb ◽  
Distal Tendon

SummaryThe purposes of this study were to determine the optimal portal location, limb position and instrumentation for arthroscopic assisted biceps tenotomy as an alternative to open tendon transection and humeral tenodesis and to evaluate anatomical location and support of the tendon following transection.Eight canine cadaver shoulder joints underwent arthroscopic visualization of bicipital tendon length via cranio-lateral and caudo-lateral camera portals in a variety of thoracic limb positions to determine maximal tendon length visualization by anatomical marking. Comparison of tenotomy time and ease was compared between radio frequency microscalpel, blade and arthroscopic shaver. Gross anatomical dissection was performed post-tenotomy to record tendon lengths, locations and supporting structures.The cranio-lateral camera port in conjunction with combined moderate shoulder and elbow flexion optimized tendon visualization, accessible length, and instrumentation ease. Visualized tendon length varied from 39-76% of total tendon length. Tenotomy times were lowest via blade and were unable to be performed with the shaver. After tenotomy the distal tendon segment remained loosely tethered within the in- tertubercular groove at the level of the intertubercular ligament by tendon sheath and capsular attachments.Biceps tenotomy is readily performed with standard arthroscopic equipment. Appropriate limb positioning and modification of previously described portals allows maximal access. Immediately posttenotomy the distal tendon is loosely maintained within the bicipital groove by tendon sheath and capsular attachments.

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