Summary
Purpose
The 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.
Methods
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.
Results
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.
Discussion
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.
Keywords
Biceps tenosynovitis - arthroscopic tenotomy - radiofrequency