Arthroscopic Suprapectoral Biceps Tenodesis Using an Onlay Technique

Tenodesis of the long head of biceps is a common shoulder surgical procedure. Tenodesis can be performed either arthroscopically or open and within the glenohumeral joint, within the bicipital groove, or below the pectoralis major tendon insertion. Arthroscopic tenodesis of the biceps tendon reduces the risk of infection. Our technique may also address persistent pain due to over tensioning of the tenodesis or from lesions hidden within the groove, such as bicipital synovitis or partial tendon tears, that are not visualized in a standard open technique. We describe an all-arthroscopic onlay technique for biceps tendon fixation at an extra-articular position within the bicipital groove, above the pectoralis major insertion. The technique uses standard arthroscopic equipment and a single knotless suture anchor.