Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Soft Tissue Biceps Tenodesis – KY -Standard posterior portal; slightly superior anterior portal (mid interval). -Grasp biceps with tissue grasper and pull into the joint and then pass a spinal needle into the posterior aspect of the tendon (through the transverse humeral ligament and the interval tissue) and feed a prolene suture and grab it out the anterior purple cannula. Tie the “shuttle single/double knot” and pass a fiberwire through the tissue and biceps tendon and pull out the anterior cannula. Grab the fiberwire that is coming out of the anterior cannula about 10 cm from cannula opening (this fiberwire has already been placed in the tendon) and place it back into the joint, pass it over the top of the biceps and carefully retrive it from underneath with a suture grasper (this loops the stitch around the biceps). Snap these two limbs together (to tie them down later or you get confused). -Repeat this step again except place the spinal needle more anterior this time. Feed a prolene suture and grab it out the anterior purple cannula. Tie the “shuttle single/double knot” and pass a fiberwire through the tissue and biceps tendon and pull out the anterior cannula. Grab the fiberwire that is coming out of the anterior cannula about 10 cm from cannula opening (this fiberwire has already been placed in the tendon) and place it back into the joint, pass it over the top of the biceps and carefully retrive it from underneath with a suture grasper (this loops the stitch around the biceps). Again snap these two together. -You should have 2 fiberwires now that are looped around the biceps (4 strands of fiberwire suture should be coming out of the skin). Now tenotomize the biceps and turn attention to the subacromial space. -Establish a lateral portal and place the anterior portal into the subacromial space. Now do a bursectomy and concentrate anteriorly to identify the sutures and retrieve them out the portals (two at a time to tie them together). This ties the biceps to the interval tissue. -Keener technique (open) is to drill a 6-7mm hole in tenodesis site, place Krackow stich in the biceps and then use 2mm drill on both medial and lateral sides of the tenodesis hole to pull the sutures through. This pulls the biceps tendon into the tunnel and then tie over the bone bridge.