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Thursday 26th Sep, 2019

Raven's Rare Shoulder Lameness

Medial displacement of the left biceps tendon due to avulsion of the left transverse humeral ligament.

Raven the SalukiWith Raven, the CT scan was invaluable in identifying the cause for her lameness: medial displacement of the left biceps tendon due to avulsion of the left transverse humeral ligament.

This was causing pain, discomfort and swelling as the biceps tendon was no longer ‘retained’ in the bicipital groove of the humerus, and was instead ‘slipping’ out of position.

To replace and stabilise the biceps tendon in the intertubercular groove we used a technique described in JSAP by Barnes (2013). This involved placing a 8mm titanium staples either side of the bicipital groove, closing the biceps tendon sheath and then placing a piece of folded polyester mesh as a ribbon through the gap beneath each staple.Raven's Staple

Taking care to not overtighten, but still adequately stabilise the biceps tendon in the bicipital groove, the mesh was tightened and then the staples fully seated in the bone. This caused the tines of the staples to grip the mesh. Postoperative radiographs showed good placement of the staples.

Raven has made good progress in the weeks following the surgery with a controlled and structured rehabilitation plan to optimise her recovery. Care has been taken to maintain her range of motion, shoulder flexibility and stabilisation, but not to overload her repair.

Medial biceps displacement is an uncommon condition, but one to bear in mind as a cause of shoulder lameness especially in sighthounds like Raven which have been shown to be at increased risk.

If you are faced with an unusual lameness, then get in touch with Ross and the Roundhouse Referrals team. We can help you out!

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