Arthroscopic Onlay Biceps Tenodesis Utilizing 2 Knotless All-Suture Anchors

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder Arthroscopy

Background:

• Biceps tenodesis is a key surgical option for pathologic long head of the biceps tendon.
• Techniques include onlay or inlay fixation, performed via open subpectoral or arthroscopic suprapectoral approaches.
• The arthroscopic suprapectoral method demonstrates comparable patient outcomes and complication rates to the subpectoral approach.

Purpose of the Study:

• To evaluate the efficacy and safety of arthroscopic suprapectoral biceps tenodesis.
• To highlight indications, technique, and outcomes of this minimally invasive procedure.

Main Methods:

• Arthroscopic identification of the biceps tendon in the bicipital groove.
• Fixation of the tendon using two knotless suture anchors in a suprapectoral location.
• Utilizing an onlay fixation technique.

Main Results:

• Excellent patient-reported outcomes with minimal complications are consistently reported.
• The arthroscopic approach reduces risks of infection, cosmetic deformity, and neurovascular injury compared to open surgery.
• Onlay fixation minimizes the risk of humeral fracture, unlike inlay fixation.

Conclusions:

• Arthroscopic onlay suprapectoral biceps tenodesis is a time-efficient, reproducible technique.
• It safely minimizes risks of humeral fracture and neurovascular injury.
• The procedure provides strong fixation and excellent patient outcomes for managing biceps tendon pathology.