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. 2021 Apr 12;10(5):e1263-e1268.
doi: 10.1016/j.eats.2021.01.022. eCollection 2021 May.

In-Office Biceps Tenotomy with Needle Arthroscopy: A Feasibility Study

Marc-Olivier Gauci  1 , Brieuc Monin  1 , Alexandre Rudel  1 , Laurent Blasco  1 , Bastien Bige  1 , Pascal Boileau  1
Affiliations

In-Office Biceps Tenotomy with Needle Arthroscopy: A Feasibility Study

Marc-Olivier Gauci et al. Arthrosc Tech. .

Abstract

Isolated pathology of the long head of the biceps is an indication for biceps tenotomy. To date, needle arthroscopy allows a direct diagnosis of shoulder lesion. We aimed to evaluate the technical feasibility of an in-office biceps isolated tenotomy by needle arthroscopy. Advantages were found in the fast-track process and the high rate of satisfaction in our selected patients. It was also a way to correct the diagnosis of torn biceps missed by the imaging. However, performing this procedure requires previous experience in conventional arthroscopy and should not be performed on anxious patients. Further studies will be necessary to confirm the reproducibility of this promising method, which could be a valuable alternative to heavy in-operating room process.

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Figures

Fig 1
Fig 1
Contrary to in-operating room procedure, the position of the screen during in-office biceps tenotomy has to be low to have a direct and comfortable view of it.
Fig 2
Fig 2
The needle arthroscopic device (NanoScope; Arthrex) is a needle arthroscopy device with a 1.9-mm scope. Technical characteristics: 400 × 400 resolution, 120-degree field of view, auto-focus from 3 mm × 100 mm. The device has a zero-degree viewing angle.
Fig 3
Fig 3
Diagnostic step and approaches for in-office biceps tenotomy. (A) The needle arthroscopy is introduced from a posterior approach. (B) The pathologic biceps and the pulley lesion are visualized and confirmed the diagnosis. (C) A needle is interiorly positioned to guide the anterior approach through the rotator cuff interval. (D) The scissors are introduced through the rotator cuff interval.
Fig 4
Fig 4
Tenotomy of the biceps. (A) Pathologic biceps observation under air needle-arthroscopy. (B) Same pathologic biceps observed after intra-articular serum injection. (C) Conventional arthroscopic scissors are introduced through the anterior approach to perform the biceps tenotomy. (F) Final result with the biceps locked in the bicipital groove. ∗ indicates biceps.
Fig 5
Fig 5
Ultrasound check before (A) and after in-office biceps tenotomy: the groove is empty (B, C) and the biceps stump is found more distally (D). (LHB, long head of the biceps.)
Fig 6
Fig 6
Skin aspect at 1 week after in-office biceps tenotomy. Scares are small or not visible (anterior [A], posterior [B]).
See this image and copyright information in PMC

References

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