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Biceps Suspension Procedure for Treatment of Painful Inferior Glenohumeral Subluxation in Hemiparetic Patients
Surena Namdari, MD, MSc1; Mary Ann Keenan, MD1
1 Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, 34th and Spruce Streets, 2nd Floor, Silverstein Building, Philadelphia, PA 19104. E-mail address for M.A. Keenan: maryann.keenan@uphs.upenn.edu
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The line drawings in this article are the work of Jennifer Fairman (jfairman@fairmanstudios.com).

Based on an original article: J Bone Joint Surg Am. 2010;92:2589-97.

Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2011 by The Journal of Bone and Joint Surgery, Inc.
JBJS Essential Surgical Techniques, 2011 Sep 14;01(02):e11 1-7. doi: 10.2106/JBJS.ST.K.00005
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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.

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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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