Anterior Cable Reconstruction Using the Proximal Biceps Tendon for Large Rotator Cuff Defects
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Updated: Nov 12, 2025

Arthroscopic Management of Massive Irreparable Rotator Cuff Tears: Whole Rotator Cable Reconstruction Using Proximal Biceps Tendon Autograft
Published on: June 6, 2025
Anthony F De Giacomo1, Maxwell C Park1, Thay Q Lee2
1Southern California Permamente Medical Group, Woodland Hills.
Abstract:
Tears of the rotator cuff tendons can occur that do not allow anatomic footprint restoration yet may not be large enough to require a superior capsular reconstruction technique. Typically, these intermediate-sized tears are addressed with a medialized repair or partial repair technique. A partially repaired rotator cuff tendon, however, can lead to a high retear rate, as the repaired tendon is required to serve as both a dynamic tendon and a static ligamentous stabilizer. One potential static support, as a nearby autologous graft donor, is the proximal long head biceps tendon. The purpose of this Technical Note is to describe a surgical technique for an anterior cable reconstruction using the proximal biceps tendon for large rotator cuff defects.

