Extension of the scapulohumeral joint increases the likelihood of success of centesis of the bursa of the biceps brachii tendon of horses

Development of a Novel Medial Synoviocentesis Approach to the Bicipital Bursa in an Equine Cadaver Model

OBJECTIVE

To describe the volume and dimensions of the bicipital bursa and its position in relation to bony and soft tissue structures, in order to develop a novel medial synoviocentesis approach to the bicipital bursa.

STUDY DESIGN

Cadaveric study.

ANIMALS

Adult equine cadaver limbs (n=19).

METHODS

Bicipital bursa dimensions, volume, and relationship to bony structures were obtained from positive contrast computed tomography images after distension of the bursa (n=7). Following an intra-bursal injection of polyurethane resin, the bicipital bursa (n=4) was dissected and its relationship to soft tissue structures described. After computed tomography and dissection, a novel medial bicipital bursocentesis approach was investigated on intact cadavers (n=8).

RESULTS

Median (range) of measurements were: length 9.02 cm (8.48-9.45 cm); width 7.06 cm (6.71-8.01 cm); and volume 51 mL (45-58 mL). The medial aspect of the bicipital bursa was located at the junction of the subclavius and biceps muscles, which corresponds with the externally visible lateral pectoral sulcus. Needle insertion 5-10 mm craniolateral to the center of the lateral pectoral sulcus midway between the palpable distal aspect of the deltoid tuberosity and the cranial part of the greater tubercle was found to be a reliable landmark for the novel medial bursocentesis approach. This approach was successful in all cadavers.

CONCLUSION

The novel approach to the bicipital bursa provided access to the medial aspect of the bursa and is an alternative to the lateral approaches. Further validation in live horses is warranted to establish the safety and efficacy of this technique.