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International Orthopaedics

, Volume 43, Issue 10, pp 2361–2365 | Cite as

In-office shoulder arthroscopy and tenotomy of the long head of the biceps tendon—a cadaveric feasibility study

  • Ion-Andrei PopescuEmail author
  • Frédéric Teboul
  • Jean-Nöel Goubier
  • Amir Ghazanfari
Original Paper
  • 32 Downloads

Abstract

Purpose

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.

Results

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.

Conclusion

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.

Keywords

In-office surgery In-office arthroscopy Shoulder arthroscopy Long head of the biceps Biceps tenotomy Massive rotator cuff tear 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

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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Copyright information

© SICOT aisbl 2019

Authors and Affiliations

  1. 1.Centre International de Chirurgie de la MainParisFrance
  2. 2.Institut de Chirurgie du Nerf et du Plexus BrachialParisFrance
  3. 3.MIRABIS Institute—Surgical Innovation CenterConstantaRomania
  4. 4.Centre Hospitalier Privé du Montgardé - SOS main-épauleAubergenvillesFrance
  5. 5.Centre Hospitalo-Universitaire de Saint-AntoineParisFrance

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