The arthroscopic “subdeltoid approach” to the anterior shoulder

Diagnostic Glenohumeral Arthroscopy Fails to Fully Evaluate the Biceps-Labral Complex

“…"Bicipital tunnel" lesions were extra-articular lesions that remained hidden from view during glenohumeral arthroscopy and the pull test but were directly visualized during subdeltoid arthroscopy 22 after release of the bicipital sheath. Although we define the bicipital tunnel as extending into the subpectoralis region, our arthroscopic technique limited visualization to the section of the bicipital tunnel between the articular margin and the proximal margin of the pectoralis major tendon, because this was the distal extent of dissection.…”

Midterm Clinical Outcomes for Arthroscopic Subdeltoid Transfer of the Long Head of the Biceps Tendon to the Conjoint Tendon

“…Furthermore, subdeltoid arthroscopy affords excellent visualization of the extra-articular anterior shoulder structures 16 (Fig 4). The musculocutaneous nerve usually pierces the conjoint tendon 4.9 cm from the tip of the coracoid but was found to have a variable range from 2.0 to 9.0 cm.…”

“…Arthroscopic subdeltoid transfer of the LHBT to the conjoint tendon was performed in accordance with previous descriptions [13][14][15][16] for chronic refractory LHBTrelated symptoms. No other tenodesis techniques were used.…”

“…Once the subdeltoid space has been exposed, 16 the LHBT is delivered through an aperture created in the bicipital sheath just proximal to the proximal margin of the pectoralis major tendon. The LHBT is then Patients who underwent arthroscopic subdeltoid LHBT transfer to the conjoint tendon from 2002 to 2008 were included.…”

“…1 Several surgical techniques have been described, including tenotomy, 4,5 open proximal biceps tenodesis, 6,7 proximal and distal arthroscopic biceps tenodesis, 8,9 subpectoral biceps tenodesis, [10][11][12] and tendon transfer to the conjoint tendon. [13][14][15][16] Drakos et al, 13 Verma et al, 14 and O'Brien et al 15,16 described arthroscopic subdeltoid transfer of the LHBT to the conjoint tendon. The proposed advantages include removal of the LHBT from its potentially pathologic extra-articular enclosure, improved cosmesis, and soft tissueetoesoft tissue fixation.…”