APEX Shoulder Mastering Surgical Techniques for Clinical Success-Shoulder Biceps

Video Transcription

Video Summary

A surgeon moderates a panel on evaluating and treating anterior shoulder pain and SLAP/biceps pathology, focusing on military and overhead athletes. Case 1: a 44-year-old active-duty man has two years of atraumatic anterior pain, positive O’Brien’s and bicipital groove tenderness, but largely benign MRI. Panelists emphasize limited reliability of MRI for SLAP lesions and overlapping symptoms with upper subscap tears. Diagnostic injections (biceps sheath ultrasound-guided or glenohumeral) can help localize pain. Arthroscopy shows an intact cuff and labrum but erythematous biceps tendon; panel discusses tenodesis techniques: high-groove anchor/cerclage methods, splitting the transverse humeral ligament to inspect groove pathology, and occasional subpectoral tenodesis (favored by some for clearer clinical feedback). Case 2: a 21-year-old volleyball player with posterior labral tear and positive dynamic posterior instability test; repair pearls include Port of Wilmington portal, bleeding bony bed, mattress/knotless fixation, and avoiding capsular capture to limit stiffness. Case 3: a 39-year-old with pan-labral tear; most recommend tenodesis over SLAP repair in this age group and staged suture passing before tying.

Asset Caption

Moderator: Andrew Sheean, M.D.
Panel: Dann Byck, M.D., Larry Field, M.D., David Richards, M.D.

Keywords

anterior shoulder pain

SLAP lesion

biceps tendon pathology

biceps tenodesis

diagnostic shoulder injection

posterior labral tear repair