The anatomy and histology of the bicipital tunnel of the shoulder

Background The bicipital tunnel is the extra-articular, fibro-osseous structure that encloses the long head of the biceps tendon. Methods Twelve cadaveric shoulder specimens underwent in situ casting of the bicipital tunnel with methyl methacrylate cement to demonstrate structural competence (n = 6)...

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Bibliographic Details
Published in:Journal of shoulder and elbow surgery 2015-04, Vol.24 (4), p.511-519
Main Authors: Taylor, Samuel A., MD, Fabricant, Peter D., MD, MPH, Bansal, Manjula, MD, Khair, M. Michael, MD, McLawhorn, Alexander, MD, MBA, DiCarlo, Edward F., MD, Shorey, Mary, BA, O'Brien, Stephen J., MD, MBA
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
biceps tendinitis
biceps tendon
bicipital tunnel
Cadaver
Female
Humans
Long head
Male
Middle Aged
Orthopedics
Pectoralis Muscles - anatomy & histology
Rotator Cuff - anatomy & histology
Shoulder - anatomy & histology
Shoulder Joint - anatomy & histology
Tendons - anatomy & histology
tenodesis
Young Adult
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Summary:Background The bicipital tunnel is the extra-articular, fibro-osseous structure that encloses the long head of the biceps tendon. Methods Twelve cadaveric shoulder specimens underwent in situ casting of the bicipital tunnel with methyl methacrylate cement to demonstrate structural competence (n = 6) and en bloc harvest with gross and histologic evaluation (n = 6). The percentage of empty tunnel was calculated histologically by subtracting the proportion of cross-sectional area of the long head of the biceps tendon from that of the bicipital tunnel for each zone. Results Cement casting demonstrated that the bicipital tunnel was a closed space. Zone 1 extended from the articular margin to the distal margin of the subscapularis tendon. Zone 2 extended from the distal margin of the subscapularis tendon to the proximal margin of the pectoralis major tendon. Zone 3 was the subpectoral region. Zones 1 and 2 were both enclosed by a dense connective tissue sheath and demonstrated the presence of synovium. Zone 3 had significantly greater percentage of empty tunnel than zones 1 and 2 did ( P  
ISSN:1058-2746
1532-6500
DOI:10.1016/j.jse.2014.09.026