"Relaxed" biceps proximal tenodesis: an arthroscopic technique with decreased residual tendon tension

Tenodesis of the long head of the biceps tendon (LHB) at the upper part of the bicipital groove has been related to persistent postoperative bicipital pain. This is possibly due to the inflammation of the remaining tendon within the groove. This, in turn, could be attributed to the continual mechanical stress placed on the tendon in the narrow bicipital groove. Theoretically, should the LHB be more "relaxed," the mechanical stress applied on it would be diminished. On the basis of this rationale, we present an arthroscopic biceps tenodesis technique, according to which the tendon is fixed at the entrance of the bicipital groove, using a bioabsorbable screw, relaxed by 5 mm. In this lax position, the residual LHB tension is expected to be decreased compared with the initial tension, whereas no cosmetic deformity (Popeye sign) or impaired muscular performance is anticipated.