Anatomic and Radiographic Comparison of Arthroscopic Suprapectoral and Open Subpectoral Biceps Tenodesis Sites

Johannsen, Adam M.; Macalena, Jeffrey A.; Carson, Eric W.; Tompkins, Marc

doi:10.1177/0363546513503812

Cited by 51 publications

(47 citation statements)

References 14 publications

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“…20,31 Our data indicate an average difference in location between techniques of 2.74 cm, which was statistically significant. This is similar to the findings of Johannsen et al, 9 who recently reported that the open subpectoral approach placed the tenodesis tunnel on average 2.2 cm further distal than the arthroscopic suprapectoral approach.…”

Section: Discussionsupporting

confidence: 91%

“…2 Numerous options for surgical approach, location, and method of fixation have been investigated for biceps tenodesis in both cadaveric and clinical studies. Long head biceps tenodesis can be performed with an open [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] or arthroscopic technique 9,18-33 and can be positioned high at the entrance of the bicipital groove, in the suprapectoral location just proximal to the pectoralis major tendon, 9,16,22,30,31,34 in a subpectoral location at or distal to the pectoralis major tendon, 6,10,12,15,16,34 or in other positions, including the conjoint tendon or soft tissue tenodesis sites. 27,32,33,35 Arthroscopic suprapectoral and open subpectoral techniques are 2 common distal techniques for biceps tenodesis.…”

mentioning

confidence: 99%

“…27,32,33,35 Arthroscopic suprapectoral and open subpectoral techniques are 2 common distal techniques for biceps tenodesis. 9 Although numerous cadaveric and biomechanical studies have assessed these methods in isolation, 4,7,17,[36][37][38][39][40][41] few studies are available that directly compare the 2 techniques. 9,39 Additionally, there has been increasing recognition that restoration of the anatomic length-tension relationship of the long head biceps is a critical aspect of the tenodesis procedure.…”

mentioning

confidence: 99%

“…9 Although numerous cadaveric and biomechanical studies have assessed these methods in isolation, 4,7,17,[36][37][38][39][40][41] few studies are available that directly compare the 2 techniques. 9,39 Additionally, there has been increasing recognition that restoration of the anatomic length-tension relationship of the long head biceps is a critical aspect of the tenodesis procedure. 22,42,43 These data are valuable to orthopaedic surgeons using these techniques, because little data exist guiding practitioners regarding the differences in these commonly used methods.…”

mentioning

confidence: 99%

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Arthroscopic Suprapectoral and Open Subpectoral Biceps Tenodesis: A Comparison of Restoration of Length-Tension and Mechanical Strength Between Techniques

Werner

Lyons

Evans

et al. 2015

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Section: Discussionsupporting

confidence: 91%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Arthroscopic Suprapectoral and Open Subpectoral Biceps Tenodesis: A Comparison of Restoration of Length-Tension and Mechanical Strength Between Techniques

Werner

Lyons

Evans

et al. 2015

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…Subpectoral fixation has been initially described [33] to reduce the rate of postoperative pain traditionally associated with arthroscopic techniques [34]. This seems related to the more distal tenodesis site achievable with subpectoral tenodesis [35]. Unfortunately, a variable spectrum of complications has been described including failure or re-rupture of the tendon, hematoma, infection, persistent pain, reaction to a fixation device, nerve injury, cosmetic deformity, and fracture [36,37].…”

Section: Discussionmentioning

confidence: 99%

Open subpectoral biceps tenodesis in patients over 65 does not result in an increased rate of complications

Voß¹,

Cerciello

Dyrna³

et al. 2017

Revue de Chirurgie Orthopédique et Traumatologique

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Background: Long head biceps tendon pathology is a common cause of anterior shoulder pain and is often associated with other shoulder conditions, such as rotator cuff tears and osteoarthritis. It is well accepted that older patients are at increased risk for major and minor peri-and postoperative complications. The purpose of this study is to investigate patients over 65 years old who underwent subpectoral biceps tenodesis and compare the complication rates of this group to those of patients younger than 65 years old. The hypothesis is, that there would be no difference in complication rates and that clinical outcome scores for patients over 65 were satisfying and showed improvements over time. Methods: There were 337 patients who underwent open subpectoral biceps tenodesis, between January 2005 and June 2015, 23 were identified as being over the age of 65 with a minimum follow up of 12 months. All patients over the age of 65 were evaluated pre-and postoperatively using Simple Shoulder Test (SST), American Shoulder and Elbow Surgeons (ASES), Constant-Murley (CM) and Single Assessment Numeric Evaluation (SANE). Intraoperative and postoperative adverse events (fracture, infection, wound opening, rupture/failure and neurovascular injuries) related to the tenodesis procedure and to the surgery itself were collected from all 337 patients in a routine postoperative follow-up. Results: The under 65 group (range 27-64 years) at an average follow up (FU) of 30 months (range 12-91 months) showed a 5.4% (17 out of 314) post-operative complication rate related to the subpectoral tenodesis, whereas the group over 65 (range 65-77 years) at an average follow up of 33 months (range 12-79 months) showed an 8.7% (2 out of 23) complication rate. Conclusion: This study demonstrates that in patients over the age of 65, biceps tenodesis is a successful procedure when performed for biceps tendinopathy and concomitantly with other surgical procedures of the shoulder, and does not result in an increased rate of complications when compared to a group of patients under the age of 65.

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Clinical relevance of the anatomy of the long head bicipital groove, an evidence‐based review

et al. 2020

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Pathology in the bicipital groove can be a source of anterior shoulder pain. Many studies have compared treatment techniques for the long head biceps tendon (LHBT) without showing any clinically significant differences. As the LHBT is closely related to the bicipital groove, anatomical aspects of this groove could also be implicated in surgical outcomes. The aim of this review is to contribute to developing the optimal surgical treatment of LHBT pathology based on clinically relevant aspects of the bicipital groove. Medline/PubMed was systematically searched using key words “bicipital” and “groove” and combinations of their synonyms. Studies reporting on evolution, embryonic development, morphometry, vascularization, innervation, and surgical treatment of the LHBT and the bicipital groove were included. The length of the bicipital groove reported in the included studies ranged from 81.00 mm to 87.33 mm, width from 7.74 mm to 11.60 mm, and depth from 3.70 mm to 6.00 mm. The anatomy of the bicipital groove shows a bottleneck narrowing approximately two‐thirds from superior. The transverse humeral ligament can constrain the bicipital groove and could be involved in anterior shoulder pain. When either LHBT tenotomy or tenodesis is performed, routinely releasing the transverse ligament could decrease postoperative anterior shoulder pain, which has frequently been reported in the literature. To avoid the bottle neck narrowing, a location below the bicipital groove may be preferred for biceps tenodesis over a more proximal tenodesis site. Level of evidence: IV.

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Anatomic and Radiographic Comparison of Arthroscopic Suprapectoral and Open Subpectoral Biceps Tenodesis Sites

Cited by 51 publications

References 14 publications

Arthroscopic Suprapectoral and Open Subpectoral Biceps Tenodesis: A Comparison of Restoration of Length-Tension and Mechanical Strength Between Techniques

Arthroscopic Suprapectoral and Open Subpectoral Biceps Tenodesis: A Comparison of Restoration of Length-Tension and Mechanical Strength Between Techniques

Open subpectoral biceps tenodesis in patients over 65 does not result in an increased rate of complications

Clinical relevance of the anatomy of the long head bicipital groove, an evidence‐based review

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