title: Feasibility of ultrasound-guided percutaneous tenotomy of the long head of the biceps tendon--A pilot cadaveric study.
abstract: 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.
authors: Health Pointe, Pain, Spine, & Sports Medicine, University of Alberta, Edmonton, Alberta, Canada.
authors: Abdel-Rahman
authors: AR
authors: Aly
authors: Health Pointe, Pain, Spine, & Sports Medicine, University of Alberta, Edmonton, Alberta, Canada.
authors: Sathish
authors: S
authors: Rajasekaran
authors: Department Anatomy and Cell Biology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
authors: Adel
authors: A
authors: Mohamed
authors: Division of Orthopaedic Surgery, Department of Surgery, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
authors: Cole
authors: C
authors: Beavis
authors: Department of Medical Imaging, Royal University Hospital, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
authors: Haron
authors: H
authors: Obaid
mesh_terms: D000369:Aged, 80 and over; D002102:Cadaver; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D012785:Shoulder Joint / Q000000981:diagnostic imaging* / Q000601:surgery*; D013710:Tendons / Q000000981:diagnostic imaging* / Q000601:surgery*; D058971:Tenotomy / Q000379:methods*; D018084:Ultrasonography, Interventional
keywords: arthroscopy; musculoskeletal; rotator cuff; tendinopathy; tendon release; ultrasonography