In-office shoulder arthroscopy and tenotomy of the long head of the biceps tendon—a cadaveric feasibility study
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Studies have shown that isolated tenotomy of the long head of the biceps (LHB) improves significantly pain scores, active range of motion and Constant score in elderly patients with massive and irreparable cuff tears with no osteoarthritis. This cadaveric study was performed to assess the feasibility of a tenotomy of the LHB and subacromial corticosteroid injection using a minimally invasive in-office setting under local anaesthesia on awake patients.
Materials and methods
Twenty scare-free shoulders were included in the study. We performed the procedure in an in-office setting using a wrist arthroscope with no fluid, connected to wireless camera and light source. A standard shoulder arthroscopy was finally performed in order to analyse the tenotomy quality and detect possible iatrogenic lesions.
The LHB tendon was cut fully in all cases, the mean length of the proximal stump of the LHB was 0.4 cm (range, 0.3–0.7 mm) and the mean duration of the surgery was 3.5 minutes (range, 2.43–3.86 min). No iatrogenic lesion occurred during the in-office procedure.
This cadaveric study suggests that it is feasible and safe to perform, under local anaesthesia, a minimally invasive arthroscopic tenotomy of the LHB and subacromial injection using an in-office setting. Further clinical studies are needed to confirm the reliability, indication and effectiveness of this technique.
KeywordsIn-office surgery In-office arthroscopy Shoulder arthroscopy Long head of the biceps Biceps tenotomy Massive rotator cuff tear
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.
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