A technique for an arthroscopic proximal biceps tenodesis using a fork anchor

Pathology to the proximal biceps tendon has the potential to be a major source of pain in the shoulder, secondary to complex superior labrum from anterior to posterior (SLAP) lesions, partial biceps tears, and subluxations. In order to restore function and improve the patient's quality of life, repair of these injuries is crucial. Tenodesis has long been the ideal treatment of persistent pain caused by pathology of the proximal biceps tendon. A biceps tenodesis helps prevent biceps pain and cramping during movement and avoids the cosmetic deformity associated with a biceps tenotomy. However, the location of the tenodesis and technique of the procedure itself have been debated throughout the literature. We present an arthroscopic biceps tenodesis technique in which the tendon is secured to the implant prior to implantation into the humerus to gain complete control of the tendon and ensure adequate fixation and tension.