SURGICAL TECHNIQUE
BICEPS TENODESIS
1
Tenodesis of the long head of the biceps is indicated for patients experiencing significant pain
associated with biceps tendonitis or tenosynovitis, instability characterized by subluxation of the
biceps tendon out of the bicipital groove, and traumatic or degenerative tearing or rupture of the long
head of the biceps tendon. Often these pathologies are secondary to SLAP lesions, subacromial
impingement, or rotator cuff tears. Benefits of surgical intervention with biceps tenodesis include re-
establishment of the length-tension relationship of the biceps tendon, preservation of elbow flexion
and supination strength, and
superior cosmetic outcomes, in
particular,
avoiding
Popeye
deformity. The Eclipse Soft
Tissue Anchor is compatible
with arthroscopic suprapectoral,
mini-open suprapectoral, and
subpectoral biceps tenodesis
procedures.
Diagnostic Arthroscopy
A diagnostic shoulder arthroscopy is performed in either the
beach chair or lateral decubitus position as per surgeon preference.
Standard posterolateral and anterior superior portals are
established.! The long head of the biceps tendon is assessed along
its intra-articular portion to confirm diagnosis of partial tearing or
SLAP tear at its insertion on the labrum. Using a probe, pull the
extra-articular biceps tendon into the joint to assess a portion of the
long head of the biceps tendon within the bicipital groove. Assess
stability of the tendon by checking the integrity of the superior
border of the subscapularis tendon.
Using an arthroscopic suture passer, place several passes of a #2 suture at the proximal aspect of
the biceps tendon to aid in tendon handling. Bring the sutures out of the anterior superior portal.
Release the biceps tendon from its insertion at the superior labrum. Debride any remaining tendon
stump on the labrum and any synovitis within the joint. Standard bursal resection and acromioplasty
are performed as indicated.
Indications