This article describes our biceps suspension procedure for painful inferior subluxation of the glenohumeral joint in hemiparetic patients.
Step 1: Position Patient and Expose the Biceps Tendon
Position the patient supine and expose the long head of the biceps tendon.
Step 2: Create Tunnel
Use a curet to connect holes drilled at the superior and inferior aspects of the lesser tuberosity.
Step 3: Prepare Biceps Tendon
Incise the tendon at the musculotendinous junction to preserve as much length of the biceps tendon as possible.
Step 4: Create Suspension
Create a loop with the tendon, and suture the distal end to the proximal end.
Step 5: Postoperative Protocol
Use a sling for three months, followed by active range-of-motion exercises.
In summary, all patients noted pain relief after surgery, ten (of eleven) noted decreased deformity, and nine were “very satisfied” with the outcome.
What to Watch For
Pitfalls & Challenges