All-arthroscopic biceps tenodesis by knotless winding suture

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder Surgery

Background:

• Biceps tenodesis is a common surgical procedure for managing biceps tendon pathology.
• Existing techniques often involve interference screws, suture anchors, or knotless anchors, each with varying complexities.
• Knot tying can be a technically demanding aspect of some tenodesis procedures.

Purpose of the Study:

• To describe a novel, knotless biceps tenodesis technique.
• To present a simplified and efficient method for biceps tendon fixation.
• To highlight the ease of performance and avoidance of knot tying in this technique.

Main Methods:

• A No. 2 nonabsorbable braided suture is passed through the lumen of a specialized hook-like instrument.
• A single hooking maneuver is used to engage and wind the entire biceps tendon.
• The suture ends are then passed through the eyelet of a knotless anchor (Bio-PushLock; Arthrex) and inserted into the bicipital groove.

Main Results:

• The described technique allows for secure biceps tenodesis without the need for intra-articular knot tying.
• The procedure is characterized by its simplicity and ease of performance.
• The use of a single hooking maneuver facilitates efficient tendon engagement.

Conclusions:

• This knotless biceps tenodesis technique offers a straightforward and effective alternative for surgeons.
• The method potentially reduces operative time and technical difficulty associated with traditional tenodesis.
• Further studies may evaluate the long-term outcomes and biomechanical properties of this technique.