Anatomic landmarks for arthroscopic suprapectoral biceps tenodesis: a cadaveric study

Area of Science:

• Orthopedic Surgery
• Anatomy

Background:

• Biceps tenodesis can cause pain if fixation is too high.
• Arthroscopic suprapectoral tenodesis offers an alternative to reduce Popeye deformity.
• Establishing precise landmarks is crucial for optimal surgical outcomes.

Purpose of the Study:

• To define anatomical landmarks for arthroscopic suprapectoral biceps tenodesis.
• To determine the ideal fixation point for optimizing long head of the biceps (LHB) muscle tension.

Main Methods:

• Dissection of 12 fresh cadaveric shoulders.
• Identification and marking of the anterior branch of the axillary nerve.
• Measurement of LHB tendon length and distances to anatomical landmarks.

Main Results:

• The suprapectoral tenodesis zone was defined between the inferior lesser tuberosity and superior pectoralis major tendon.
• A consistent branch of the anterior humeral circumflex artery was identified as a reliable landmark within this zone.
• The distance from the LHB tendon to this vessel varied between sexes, providing tensioning guidance.

Conclusions:

• The anterior humeral circumflex artery branch serves as a reliable landmark for suprapectoral tenodesis.
• Accurate landmark identification ensures appropriate LHB tensioning during arthroscopic procedures.
• This technique aids in preventing Popeye deformity and associated pain.