Endoscopy Case Study

Courtesy of
Kurt S. Schulz, DVM, MS, Diplomate ACVS
Associate Professor of Small Animal Surgery
University of California, Davis.

Tenotomy of partially torn biceps tendon

A 4 year old Shepard mix was presented for a several month history of left forelimb lameness. On physical examination there was marked atrophy of the muscles of the left forelimb and moderate atrophy of the muscles of the right forelimb. The dog had a moderate weightbearing lameness of the left forelimb and pain on palpation of the left shoulder joint. The pain was particularly evident upon palpation of the proximal biceps tendon.

Figure 1

Radiographs of both shoulders showed mild osteoarthritic changes. Ultrasound of both shoulders was performed. On the left shoulder there was loss of clarity of the proximal biceps tendon suggestive of severe inflammation or partial tear. On the right shoulder there was a complete absence of tendon pattern in the proximal region suggestive of a complete biceps tendon tear.

Figure 2

Arthroscopy demonstrated partial tearing of the biceps tendon.
(Figures 1 and 2)

Figure 3 - The tendon was transected

Figure 4 - Shows the tendon after complete release.

Comment. In the past, biceps tendon disease was treated by transposition of the insertion to the proximal humerus. Transection alone has been shown to be effective and is quickly and easily achieved with arthroscopy. Arthroscopy also enables complete exploration of the joint which is important as other damage including that to the medial ligaments or humeral head have been identified in these cases.