• John Prodromo, Mary K Mulcahey, Raymond Hong, and Tal S David.
• Department of Orthopedic Surgery, Drexel University College of Medicine/Hahnemann University Hospital, Philadelphia, Pennsylvania.
• Surg Technol Int. 2015 Nov 1; 27: 219-24.

BackgroundSuccessful tenodesis of the proximal biceps relies on accurate reproduction of the native length-tension relationship of the long head of the biceps (LHB). While open tenodesis procedures can reproduce this relationship by referencing the position of the LHB musculotendinous junction (MTJ) to a visible anatomic landmark, arthroscopic suprapectoral tenodesis does not afford such advantage because the MTJ is usually not visible. No studies to date have evaluated the position of the MTJ of the LHB following arthroscopic suprapectoral biceps tenodesis.MethodsPatients undergoing arthroscopic suprapectoral biceps tenodesis between January 2013 and May 2014 at one center were evaluated for inclusion. Patients included in the study underwent a postoperative MRI of bilateral shoulders. The distance from the superior portion of the humeral head to the LHB MTJ was measured bilaterally. The measurements from each matched pair were compared using a paired t-test to determine if arthroscopic suprapectoral biceps tenodesis anatomically restored the LHB length-tension relationship.ResultsA total of 17 patients met the inclusion criteria. Fourteen of the seventeen patients underwent a postoperative MRI of bilateral shoulders. The distance from the superior portion of the humeral head to the LHB musculotendinous junction was significantly larger on the operative side when compared to the nonsurgical side (operative side mean 98.34 mm, standard deviation 13.38 mm; nonsurgical mean 87.26 mm, standard deviation 9.09; mean difference 11.08 mm; p=0.0105).ConclusionThe musculotendinous junction of the LHB in patients who underwent arthroscopic suprapectoral biceps tenodesis was located significantly more distal than the contralateral control, as measured on MRI.

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