Management of proximal biceps tendon pathology

One-Step Release Technique for Tendon Extraction During Biceps Tenodesis

All biceps tenodesis techniques involving extra-articular tendon preparation consist of 2 distinct steps for tenotomy and tendon grasping. These 2 maneuvers are performed by different instruments. A single-step tendon release technique is described for both arthroscopic and open shoulder surgery. This technique finds application in arthroscopic proximal suprapectoral tenodesis, open treatment of proximal humerus fractures, and suprapectoral mini-open tenodesis. Herein, we describe an arthroscopic biceps tenodesis technique that combines the actions of cutting and gripping the tendon in a single step.

Nonoperative Treatment of the Biceps-Labral Complex

The long head of the biceps and superior labrum should be evaluated as an interdependent functional unit. A focused patient history and physical examination including multiple provocative tests should be performed alongside advanced imaging studies to obtain an accurate diagnosis. Nonoperative treatment modalities including nonsteroidal anti-inflammatory drugs, glucocorticoid injections, and a standardized physical therapy regimen should be exhausted before operative intervention. Significant improvements in pain, functional outcomes, and quality of life are achieved in patients treated nonoperatively. Although these outcomes are less consistent for overhead athletes, return to play and performance metrics seem comparable to those who undergo surgery.

Fast Arthroscopic Biceps Tenodesis Without Penetrating Grasper

Long head of the biceps pathology is a common cause of shoulder pain and dysfunction. Surgical treatment can be either a tenotomy or a tenodesis. Long-term results may be similar in both surgical techniques; however, the latest systematic reviews indicate that tenodesis offers superior clinical and functional results in young patients and athletes. Considering the favorable results with the biceps tenodesis, we present this arthroscopic tenodesis in which the long head of the biceps is fixed in the bicipital groove with an all-suture anchor passed directly through the tendon, providing a stable and fast fixation without using penetrating grasper.

Simple Soft Tissue Biceps Tenodesis

This article describes a simple all soft tissue technique for arthroscopic long head of the biceps tenodesis to the subscapularis tendon using posterior and anterior portals. The technique uses a PDS suture that assists in passing a braided suture through both the biceps tendon and the subscapularis to allow for the desired tenodesis. This technique is simple, safe, efficient, and less costly than other techniques.