A Simple Surgical Technique for Subpectoral Biceps Tenodesis Using a Double-Loaded Suture Anchor CPT William F. Scully, M.D., CPT David J. Wilson, M.D.,

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Presentation transcript:

A Simple Surgical Technique for Subpectoral Biceps Tenodesis Using a Double-Loaded Suture Anchor CPT William F. Scully, M.D., CPT David J. Wilson, M.D., MAJ Jason A. Grassbaugh, M.D., MAJ Joanna G. Branstetter, M.D., LTC Bryant G. Marchant, M.D., COL Edward D. Arrington, M.D. Arthroscopy Techniques Volume 2, Issue 2, Pages e191-e196 (May 2013) DOI: 10.1016/j.eats.2013.02.005 Copyright © 2013 Terms and Conditions

Fig 1 Standard beach-chair positioning for subpectoral biceps tenodesis. The patient's arm is typically abducted and externally rotated to allow access to the anteromedial proximal arm. The planned incision is marked. Arthroscopy Techniques 2013 2, e191-e196DOI: (10.1016/j.eats.2013.02.005) Copyright © 2013 Terms and Conditions

Fig 2 Instruments required for our procedure include (from left to right) the Mitek drill guide, the Mitek 2.9-mm drill, and a rasp for preparing the docking site. Arthroscopy Techniques 2013 2, e191-e196DOI: (10.1016/j.eats.2013.02.005) Copyright © 2013 Terms and Conditions

Fig 3 Blindly positioning drill guide in line with bicipital groove, 1 cm proximal to inferior border of pectoralis major muscle. Arthroscopy Techniques 2013 2, e191-e196DOI: (10.1016/j.eats.2013.02.005) Copyright © 2013 Terms and Conditions

Fig 4 Drilling unicortical hole for anchor placement. The drill guide position is maintained after the drill is removed for ease of anchor placement. Arthroscopy Techniques 2013 2, e191-e196DOI: (10.1016/j.eats.2013.02.005) Copyright © 2013 Terms and Conditions

Fig 5 Double-loaded Lupine anchor on metal inserter handle. Arthroscopy Techniques 2013 2, e191-e196DOI: (10.1016/j.eats.2013.02.005) Copyright © 2013 Terms and Conditions

Fig 6 Placement of Lupine anchor through drill guide. Arthroscopy Techniques 2013 2, e191-e196DOI: (10.1016/j.eats.2013.02.005) Copyright © 2013 Terms and Conditions

Fig 7 Suturing of proximal aspect of biceps tendon. Arthroscopy Techniques 2013 2, e191-e196DOI: (10.1016/j.eats.2013.02.005) Copyright © 2013 Terms and Conditions

Fig 8 Excision of excess proximal tendon. Arthroscopy Techniques 2013 2, e191-e196DOI: (10.1016/j.eats.2013.02.005) Copyright © 2013 Terms and Conditions

Fig 9 Shuttling tendon into position by pulling on 2 suture posts. Arthroscopy Techniques 2013 2, e191-e196DOI: (10.1016/j.eats.2013.02.005) Copyright © 2013 Terms and Conditions

Fig 10 Artistic rendition of our subpectoral biceps tenodesis technique, with surrounding anatomic structures highlighted. Arthroscopy Techniques 2013 2, e191-e196DOI: (10.1016/j.eats.2013.02.005) Copyright © 2013 Terms and Conditions