Division of Sports Medicine, Orthopaedic Specialty Institute, Medical Group of Orange County, Orange, CA, USA.
Division of Sports Medicine, Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL, USA.
J ISAKOS. 2022 Aug;7(4):84-85. doi: 10.1016/j.jisako.2022.03.004. Epub 2022 Mar 31.
Long head biceps tendinopathy can be a significant pain generator, often presenting with pain localised to the anterior shoulder. Biceps tenodesis, both open and arthroscopic, is a well-established treatment for long head biceps pathology. In this presentation, we describe a novel arthroscopic onlay technique for long head biceps tenodesis using a lasso configuration with two knotless suture anchors that provide an efficient, low-profile construct to limit scarring and adhesions while providing circumferential fixation. We use this technique for the following surgical indications: severe tendinosis refractory to non-operative management, unable superior labral anterior to posterior (SLAP) tears, biceps instability and partial or complete tearing. The procedure is performed using standard shoulder arthroscopy portals with the addition of an anterolateral biceps working portal approximately 2 cm inferior and 2 cm lateral to the anterior rotator interval portal. Novel advantages of this technique include a low-profile knotless construct, efficient suture passage and circumferential two-point fixation while maintaining anatomic biceps tensioning. Technical pearls including visualisation, release of the biceps tendon from the groove and location of two point tenodesis fixation are all critical to a good outcome.
肱二头肌长头肌腱病可引起明显疼痛，常表现为肩部前侧疼痛。肱二头肌肌腱切断术，包括开放和关节镜两种方式，是治疗肱二头肌长头肌腱病的成熟方法。在本次演讲中，我们描述了一种使用套索结构的新型关节镜肱二头肌长头肌腱固定术的外侧技术，该技术使用了两个无结缝线锚钉，可提供有效的低轮廓结构，以限制疤痕和粘连，同时提供圆周固定。我们将该技术用于以下手术适应证：对非手术治疗无反应的严重肌腱病、无法进行肩盂上唇从前向后（SLAP）撕裂修复、肱二头肌不稳定和部分或完全撕裂。该手术采用标准肩关节镜入路，并在前旋转间隔入路的前外侧增加一个大约 2cm 下、2cm 外侧的肱二头肌工作入路。该技术的新颖优势包括低轮廓无结结构、有效的缝线通过和圆周两点固定，同时保持肱二头肌的解剖张力。可视化、从凹槽中释放肱二头肌肌腱以及两点固定的位置等技术要点对于获得良好效果至关重要。
