Table 2.

Advantages, Risks, and Limitations of Biceps Tenoscopy

Advantages

Allows visualization of the full extent of the extra-articular long head of biceps (LHB) tendon that is not seen using standard glenohumeral joint arthroscopy.

Standard glenohumeral arthroscopy is reported to be associated with a 30% to 50% rate of missed diagnoses. Biceps tenoscopy has the potential to reduce this by improved visualization.

This technique allows therapeutic procedures to be performed within the bicipital groove. Standard techniques do not allow intragroove procedures (e.g., excision of osteophyte and debridement of tendinopathic lesion).

This technique requires no additional equipment.

Risks/Limitations

In addition to the risks of standard glenohumeral arthroscopy the following should be considered:

The risk of compartment syndrome after established arthroscopic procedures is very low. Appropriate precautions to minimize the risk include the avoidance of high pump pressures and visual intraoperative monitoring of swelling.

There is a potential risk of neurologic injury, however, by staying anterior to the LHB tendon when entering the groove and bringing the arthroscope out from the premarked skin incision; this risk is extremely low as both median and radial nerves do not lie anterior to the humerus at this level and are medial to it. The musculocutaneous nerve lies deep to the biceps muscle belly and is therefore protected by it.