title: Tenoscopic Suprapectoral Biceps Tenodesis.
abstract: Existing arthroscopic techniques of proximal biceps tenodesis may be complicated by difficulty of tendon identification, restoration of length-tension relation, cosmetic deformity, persistent biceps pain, and shoulder stiffness requiring surgical revision in a relevant proportion of cases. In this context, biceps tenoscopy, an emerging discipline of shoulder endoscopy, offers major benefits. Tenoscopy comprises endoscopic treatment of tendons and tendon sheaths. The presented technique of tenoscopic suprapectoral biceps tenodesis (TSBT) substantially facilitates tendon identification and reduces invasiveness by avoidance of unnecessary surgical involvement of the deltoid space and bursa. TSBT enables effective treatment of the biceps tendon and surrounding tissues (biceps tendon sheath, tenosynovium, transverse humeral ligament) being consistently involved in proximal biceps pathologies. The physiological length-tension relation of the musculotendinous unit is reliably maintained. Technically, the procedure of tenodesis is simplified and accelerated by redundancy of tendon exteriorization. The aforementioned benefits of TSBT may lead to superior clinical and cosmetic outcomes and lower incidences of persistent proximal biceps pain and postoperative shoulder stiffness compared with conventional techniques of arthroscopic biceps tenodesis.
authors.affiliation: Department of Orthopedic and Trauma Surgery, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Maier
authors.affiliation: Department of Orthopedic and Trauma Surgery, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Kaywan
authors.initials: K
authors.lastname: Izadpanah
authors.affiliation: Department of Orthopedic and Trauma Surgery, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Jaeger
authors.affiliation: Center of Orthopedic Sports Medicine Freiburg, Freiburg, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Ogon
authors.affiliation: Department of Orthopedic and Trauma Surgery, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Norbert P
authors.initials: NP
authors.lastname: Südkamp