Arthroscopic Biceps Tenodesis to Supraspinatus Tendon: Technical Note

Abstract not available. Introduction provided instead.

Open or arthroscopic biceps tenodesis is performed when the proximal biceps tendon is thought to be a pain generator. The biceps tendon generates pain, it is believed, in partial-thickness tears of the biceps, in biceps instability, and in biceps tendinopathy, often occurring with rotator cuff pathology and affecting shoulder biomechanics. Management of biceps tendon pathology has been a subject of much interest among shoulder surgeons. Several techniques for tenodesis of the biceps tendon have been described, but few incorporate the biceps into the rotator cuff tendon. These studies have involved techniques that provide a secure tenodesis and fewer incisions with good results.^1-7

A new technique developed by the senior author (L.L.) incorporates the long head of the biceps tendon with the supraspinatus in patients with anterosuperior rotator cuff tears. Tenodesing the biceps to the supraspinatus theoretically creates opposing forces that help to depress the humeral head and restore some function of the biceps tendon as a dynamic stabilizer. Although this rationale is not supported by biomechanical studies, we have had good results with this technique.