Arthroscopic Treatment of Isolated Type II SLAP Lesions

Abstract

Arthroscopic biceps tenodesis can be considered an effective alternative to the repair of a type II SLAP lesion, allowing patients to return to a presurgical level of activity and sports participation. The results of biceps reinsertion are disappointing compared with biceps tenodesis. Furthermore, biceps tenodesis may provide a viable alternative for the salvage of a failed SLAP repair. As the age of the 2 treatment groups differed, these findings should be confirmed by future studies.

Suprapectoral or subpectoral position for biceps tenodesis: biomechanical comparison of four different techniques in both positions

“…The position of 10 mm distal from the entrance of the bicipital groove for the suprapectoral position [3][4][5][6]15,19,25,26 and 50 mm for the subpectoral position 8,19,20 was chosen in accordance with previous published studies and our own measurements of the upper border (47 AE 6.56 mm; range, 35-60 mm) and the lower border (105 AE 7.65 mm; range, Furthermore, we could neither rule out nor confirm potential differences between the suprapectoral and subpectoral position of tenodesis regarding postoperative pain caused by a too proximally fixed biceps tendon. Especially the type of a degenerative changed hourglass biceps tendon 2,29,30 probably cannot be resected completely in suprapectoral techniques, leaving potentially too much of the proximal biceps tendon in place.…”

“…The localization for the suprapectoral tenodesis was chosen 10 mm distal from the entrance of the bicipital groove, [4][5][6]22,26,27 and the position for the subpectoral tenodesis was placed 50 mm distal from the entrance of the bicipital groove under the superior border of the pectoralis major insertion. 19,20 The specimens were divided randomly into 6 groups, resulting in 7 specimens per group.…”

“…1,7,10,12,16,17,23,[27][28][29][30] LHB tenodesis has been shown to be an appropriate therapy for LHB partial tears, biceps pulley lesions, and superior labrum anteroposterior (SLAP) lesions. 5,6 Several studies have described and evaluated different techniques for LHB tenodesis. [4][5][6]8,9,11,14,15,18,[20][21][22]24,26,27,31 LHB tenodesis can be performed open, 8,11 minimally open, 19,20 or arthroscopically.…”

“…[4][5][6]8,9,11,14,15,18,[20][21][22]24,26,27,31 LHB tenodesis can be performed open, 8,11 minimally open, 19,20 or arthroscopically. [3][4][5]15,19,22,26,27 Among the options described for the position of the tendodesis are the suprapectoral position [3][4][5][6]15,19,25,26,27 at the entrance of the bicipital groove, and the subpectoral position 8,11,[19][20][21] under the tendon of the pectoralis major muscle. Suprapectoral tenodesis is easy to perform arthroscopically, [3][4][5][6]15,18,22,26,…”

“…[3][4][5]15,19,22,26,27 Among the options described for the position of the tendodesis are the suprapectoral position [3][4][5][6]15,19,25,26,27 at the entrance of the bicipital groove, and the subpectoral position 8,11,[19][20][21] under the tendon of the pectoralis major muscle. Suprapectoral tenodesis is easy to perform arthroscopically, [3][4][5][6]15,18,22,26,27 whereas the subpectoral tenodesis is performed in a minimally open procedure or by an open procedure with a longitudinal skin incision at the lower border of the pectoralis major muscle. [19][20][21] Several fixation techniques and devices for biceps tenodesis have been described, including interference screws 4,11,14,18,21,22,25,26,27,31 and suture anchors.…”