Subpectoral Biceps Tenodesis using Cortical Buttons
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Surgical Technique Subpectoral Biceps Tenodesis Subpectoral Biceps Tenodesis using Cortical Buttons

Subpectoral Biceps Tenodesis using Cortical Buttons Introduction Subpectoral biceps tenodesis using cortical buttons and the tension slide technique allows the surgeon to tension and repair the long head of the biceps in either a bicortical or unicortical repair. The bicortical technique utilizes the BicepsButton to draw the tendon against the distal cortex of the bone socket. A tenodesis screw may be added to further augment the repair. The unicortical technique utilizes the 8.5 mm long Proximal Tenodesis Button, which has angled edges to promote a toggle effect when the button contacts...

Ordering Information Bicortical Subpectoral Tenodesis Distal Biceps Repair Implant System (includes BicepsButton, Button Inserter, FiberLoop, 7 mm x 10 mm PEEK Tenodesis Screw and 3.2 mm Drill Pin) AR-2260 #2 FiberLoop w/straight needle AR-7234 PEEK Tenodesis Screw, 7 mm x 10 mm AR-1670PS Required Instruments: Included in Bio-Tenodesis Screw System (AR-1675S): Driver for Bio-Tenodesis Screws ART670DB-01 Tear Drop Handle w/ Suture Cleat AR-2001BT Headed Reamer, 7 mm, cannulated ART407 Required Disposables: Free Needle w/Nitinol Loop AR-7281 Nitinol Suture Passing Wire AR-1255-18 Unicortical...

Bicortical Subpectoral Biceps Tenodesis Retrieve the biceps through the incision. Using the FiberLoop, whipstitch the tendon approximately 2 cm starting at the musculotendinous junction. Trim the excess tendon and measure the diameter. 3 Drill a 3.2 mm bicortical tunnel 1 cm above the inferior border of the pectoralis tendon and ream a unicortical hole, which is line-to-line with the biceps tendon. Thread one limb of suture through one side of the BicepsButton and back through the opposite side. Thread the other suture limb through the button in the same manner, starting on the opposite...

Pull on the free suture limbs to seat the button against Once the tendon is fully seated, use a free needle and the humerus. Tension each suture limb to dock the pass one suture limb through the tendon and tie a tendon into the bone tunnel. knot. Use a knot pusher if necessary. If the surgeon chooses to incorporate a Tenodesis Tie the suture limbs over the screw to complete the Screw into the repair, load the screw onto the repair. Tenodesis driver and load one suture limb through the driver. Insert the screw so it seats flush with the anterior cortex.

Unicortical Subpectoral Biceps Tenodesis Retrieve the biceps through the incision. Using the FiberLoop, whipstitch the tendon approximately 2 cm starting at the musculotendinous junction. Trim the excess tendon and measure the diameter. 3 Drill a unicortical hole in the humerus 1 cm above the inferior border of the pectoralis tendon using the 3.2 mm Drill Pin. The Shoehorn Cannula can be used as a soft tissue protector. Thread the sutures through the Proximal Tenodesis Button the same way as in Step 2 in the Bicortical Technique. The suture limbs should exit on the long side of the button...

5 Pull on the free suture limbs to reduce the tendon onto the humerus. 6 Once the tendon is fully reduced, use the Free Needle to pass one limb of suture through the tendon and tie a knot to complete the repair.

www.arthrex.com ...up-to-date technology just a click away These surgical techniques were developed in cooperation with Thomas Hackett, M.D., Vail, CO, Paul Sethi, M.D., Greenwich, CT, Reuben Gobezie, M.D., Cleveland, OH and partially based on the paper: Mithoefer K. Subpectoral Biceps Tenodesis Using Dynamic Endobutton Fixation in a Humeral Bone Tunnel With Interference Screw Augmentation. Techniques in Shoulder & Elbow Surgery 2011; 12(3):51-75. This description of technique is provided as an educational tool and clinical aid to assist properly licensed medical professionals in the usage...