At this year’s ASMI Injuries in Baseball course, one of the topics that we discussed at length was the use of biceps tendodesis in baseball pitchers. Over the years, our understanding of SLAP lesions has evolved and many are advocating a biceps tenodesis procedure. While this may be a viable option for older individuals, I have never been a fan of this in athletes that need to use their shoulder at maximum range of motion and velocity. I just don’t think the concept of “if it hurts just cut if off” makes the most sense to me.
SEE ALSO: Is Biceps Tenodesis the Answer?
A recent case report in AJSM actually describes one of the biggest reasons why I am think we really need to question the use of biceps tenodesis in baseball pitchers: A humeral fracture.
The white arrow is the drill hole from the biceps tenodesis. This came up at the ASMI course with the panel of surgeons, including Dr. James Andrews, Dr. Lyle Cain, and Dr. Xavier Duralde of the Braves. The rotational torque observed on the humerus while pitching are extremely high. Putting a screw in there scares me a bit.
SEE ALSO: Dr. Lyle Cain from the American Sports Medicine Institute discusses some facts and fiction related to the biceps tenodesis surgery.
What do you think? Does this x-ray of a humeral fracture following a biceps tenodesis in a baseball pitcher scare you a little too?