Ultrasound-Guided Biceps-Tracking Access to the Superior Labral-Biceps Anchor Complex: A Technical Report With...

Area of Science:

• Orthopedic Surgery
• Musculoskeletal Imaging
• Ultrasound-Guided Procedures

Background:

• The superior labral-biceps anchor complex is challenging to target with ultrasound due to its deep location and surrounding structures.
• Current ultrasound-guided injections for labral pathology often target the glenohumeral joint rather than the specific footprint.

Purpose of the Study:

• To describe and demonstrate a structured ultrasound-guided biceps-tracking approach for targeting the superior labral-biceps anchor complex.
• To assess the feasibility of accurate injectate localization at the footprint level using this technique in a cadaveric model.

Main Methods:

• A structured ultrasound-guided biceps-tracking approach was developed.
• A fresh-frozen cadaver was used for bilateral injections into the superior labral-biceps anchor complex using a 23-gauge needle and stained filler.
• Layer-by-layer dissection was performed to evaluate gross injectate localization.

Main Results:

• Ultrasound guidance allowed for sequential tracking of the biceps tendon to its intra-articular origin.
• Cadaveric dissection confirmed focal filler localization at the supraglenoid tubercle/biceps anchor region in both shoulders.
• No significant diffuse pooling within the glenohumeral joint or unintended spread was observed.

Conclusions:

• The described ultrasound-guided biceps-tracking approach shows preliminary anatomical feasibility for footprint-level access to the superior labral-biceps anchor complex.
• Further studies are needed to establish reproducibility, safety, accuracy, and clinical efficacy due to the limitations of this cadaveric study.