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Medical Student Research Education and Simulation

08 SUBPECTORAL BICEPS TENODESIS: ANATOMICAL CONSIDERATIONS AND CLINICAL CORRELATIONS FOR BICEPS TENDINOPATHY

Nicolas Kress, MS, OMS-II; Tiffany Carpenetti, PhD; Ryan Miyamoto, MD Corresponding author: nkress@vcom.edu

VCOM-Virginia, Blacksburg, Virginia

and extra- articular pathology with associated pain relief, improved function, and reduced bicipital groove symptoms. Objective: The aim of this project is to evaluate indications, clinical relevance, and outcome profile of subpectoral biceps tenodesis to obtain a better understanding of it use in managing pathology of the long head of the biceps tendon. This project also serves to highlight relevant anatomy pertaining to the orthopedic surgical procedure on one side of the donor, while imitating the procedure on the contralateral side. Methods: Standard dissection protocols based on Grant’s Dissector, with minor modifications, were applied to one side of the donor, while the contralateral side was approached surgically. Clinical Correlations: Despite the growing popularity of the subpectoral biceps tenodesis, further questions

regarding the optimal indications, mechanical advantages, as well as long-term function outcomes across a variety of populations still remain. A better understanding of the procedure and its role in modern-day shoulder surgery is critical in terms of guiding future surgical decision making and refining rehabilitation strategies. Conclusion: Subpectoral biceps tenodesis represents a clinically meaningful option for the management of pathology of the long head of the biceps tendon, especially in patients with symptomatic SLAP tears, bicipital groove symptoms, of degenerative intra-articular biceps tendon pathology. Addressing both intra- and extra- articular sources of pain, this technique provides appreciable reduction in

Introduction: One of the most frequent sources of anterior shoulder pain and functional limitation is pathology of the long head of the biceps tendon. Several pathologies, including superior labrum anterior to-posterior (SLAP) lesions, biceps tendinopathy, and instability within the bicipital groove, often coincide with rotator cuff tears and degenerative labral changes, which ultimately make diagnosis and treatment quite difficult. Traditional SLAP repairs have shown variable outcomes, leading to increased interest in alternative surgical approaches. The subpectoral biceps tenodesis has become increasingly favorable for managing pathology of the long head of the biceps tendon because of its ability to remove diseased tendon, eliminate bicipital groove irritation, and restore the physiologic length-tension relationship of the biceps. In a subpectoral biceps tenodesis, the long head of the biceps tendon is secured distal to the pectoralis major tendon, allowing for adequate management of intra-

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164 Edward Via College of Osteopathic Medicine (VCOM)