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Feasibility of ultrasound‐guided percutaneous tenotomy of the long head of the biceps tendon—A pilot cadaveric study
Author(s) -
Aly AbdelRahman,
Rajasekaran Sathish,
Mohamed Adel,
Beavis Cole,
Obaid Haron
Publication year - 2014
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.22189
Subject(s) - medicine , tenotomy , cadaveric spasm , biceps tendon , percutaneous , biceps , ultrasound , tendon , surgery , head (geology) , anatomy , radiology , geomorphology , geology
Objective To describe an ultrasound‐guided proximal percutaneous tenotomy technique of long head of the biceps tendon (LHBT). Methods Three fresh cadavers with no prior shoulder surgery or LHBT tears were included in the study. A single experienced musculoskeletal radiologist completed six ultrasound‐guided proximal percutaneous tenotomies of LHBT. A superficial to deep approach was performed on four shoulders using an arthroscopic banana blade or retractable blade. A deep to superficial approach was performed on two shoulders using an arthroscopic hook blade. A blinded anatomist dissected each specimen and graded the tenotomy, length of proximal LHBT stump, and evidence of iatrogenic injuries. Results Four of the six cadaveric LHBTs were fully transected. The two partially transected tenotomies were performed using the arthroscopic banana and retractable serrated blades (63% and 80% transections, respectively). The proximal LHBT stump mean length was 2.6 cm (95% CI, 1.8–3.4). There was no evidence of iatrogenic lesions. Conclusions This cadaveric study showed that the ultrasound‐guided percutaneous tenotomy of the LHBT is a feasible procedure. The deep to superficial approach using an arthroscopic hook blade resulted in complete transection. Further cadaveric studies with larger numbers are warranted to confirm this novel technique's applicability in clinical practice. © 2014 Wiley Periodicals, Inc. J Clin Ultrasound 43 :361–366, 2015