Course Lecture Pearls: Arthroscopic Shoulder Solutions-Cases from the Jersey Shore-Joseph C. Tauro, M.D.

Video Transcription

Video Summary

The lecture discusses the diagnosis and surgical management of shoulder injuries, particularly focusing on rotator cuff tears and biceps tendon lesions. A case with a one-year history of shoulder pain and previous failed treatments is examined arthroscopically, revealing an upper subscapularis tear, supraspinatus tear, and a biceps pulley lesion causing biceps tendon instability. The importance of addressing the biceps lesion, often with tenodesis rather than simple tenotomy, is emphasized to prevent ongoing pain and dysfunction. Various surgical techniques are described, including subscapularis repair via arthroscopic portals, and options for supraspinatus repair (single vs. double row, knot-tying techniques). Portal positioning is highlighted to improve visualization during surgery. The lecture also details different biceps tenodesis methods—open subpectoral, suprapectoral arthroscopic, and a simpler "El Cheapo" approach using sutures to fix the tendon after tenotomy. Considerations include fixation strength, risk of humeral fractures (notably with low humeral tenodesis due to large drill holes), and maintaining proper tendon length to preserve function. The speaker encourages tailoring repair techniques to tissue quality and shares practical tips, such as marking drill holes to aid anchor placement and debating whether to tie sutures medially in double-row repairs. Overall, the talk combines technical insights with clinical decision-making nuances in shoulder arthroscopy and biceps management.

Keywords

shoulder injuries

rotator cuff tears

biceps tendon lesions

arthroscopic surgery

subscapularis repair

supraspinatus repair

biceps tenodesis techniques

shoulder arthroscopy