Arthroscopic biceps tendon tenodesis: the anchorage technical note

Treatment of long head biceps (LHB) tendon pathology has become an area of renewed interest and debate among orthopaedic sur- geons in recent years. The back- ground of this manuscript is a description of biceps tenodesis which ensure continual dynamic action of the tendon which depresses the head and impedes lateral translation. A new technique has been developed in order to treat LHB tendon irrevers- ible structural abnormalities associ- ated with cuff rotator lesions. This technique entails the construction of a biological anchor between the LHB and supraspinatus and/or in- fraspinatus tendons according to arthroscopic findings. The rationale, although not supported by biome- chanical studies is to obtain a triple, biomechanical effect. The first of these biomechanical effects which we try to promote through the proce- dure of transposition is the elimina- tion of the deviation and oblique angle which occurs as the LHB completes its intra-articular course prior to reaching the bicipital groove. Furthermore, we have found this technique extremely useful in the presence of large ruptures of the rotator cuff with muscle retraction. The most common complication associated to this particular method, observed in less than 3%, is failed biological fixation which manifests as subsidence of the tenodesis and consequent descent of the tendon with evident aesthetic deformity.