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There are multiple congenital differences in the anatomy of the long head biceps tendon origin, course, and sling. Here, we report a case of biceps tendon congenital accessory superior glenohumeral ligament (SGHL) and biceps tendon fused to anterior superior capsule under the coracohumeral ligament without a history of prior shoulder surgery or trauma, “the Aggeris Fusion.” The diagnosis of this fusion was possible with “the Ramp Test,” originally described by the senior author. “The Ramp Test” was developed to evaluate biceps intra-articular pathology and ultimately diagnose the biceps “Hidden Lesion,” described by Walch et al. The reported lesion was found to have a negative (abnormal) Ramp Test, due to the abnormal, congenital fusion. The fusion was released arthroscopically. Postoperatively, the patient progressed successfully. The patient achieved a full range of motion and reports no pain.

duke orthopaedic journal/duke orthopaedic  journal

Proximal Biceps Tendon Congenital Accessory Superior Glenohumeral Ligament and Biceps Tendon fused to Anterior Superior Capsule Under the Coracohumeral Ligament: The Aggeris Fusion