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Subpectoral Biceps Tenodesis Using an All-Suture Anchor.

Yazdan Raji1, George Bugarinovic1, Kevin N Helenius1

  • 1Department of Orthopaedic Surgery, Stanford University, Redwood City, California, USA.

Video Journal of Sports Medicine
|May 1, 2025
PubMed
Summary

Open subpectoral biceps tenodesis effectively treats shoulder pain from the long head of the biceps tendon (LHBT). This surgical technique offers low complication rates and high patient satisfaction for recalcitrant cases.

Keywords:
biceps tendinopathyopen biceps tenodesisshoulder arthroscopysurgical technique

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Area of Science:

  • Orthopedic Surgery
  • Shoulder Arthroscopy
  • Sports Medicine

Background:

  • The long head of the biceps tendon (LHBT) is a common intra-articular shoulder pain source.
  • Nonoperative treatments are suitable for mild LHBT pathology, but surgical options like tenotomy and tenodesis are debated for severe cases.
  • Open subpectoral biceps tenodesis offers pathologic tissue removal and utilizes all-suture anchor fixation to minimize risks like stress risers and fractures.

Purpose of the Study:

  • To present a case of open subpectoral biceps tenodesis for recalcitrant shoulder pain.
  • To detail the surgical technique, including incision placement, fixation methods, and tensioning of the LHBT.
  • To review outcomes, postoperative care, and rehabilitation following the procedure.

Main Methods:

  • The study focuses on the open subpectoral biceps tenodesis component of a larger shoulder surgery.
  • Key techniques highlighted include precise skin incision in the axillary crease, skin tensioning, and a locking lasso loop with double luggage tag fixation using an all-suture anchor.
  • The procedure was performed on a male patient with persistent left anterolateral shoulder pain unresponsive to conservative management.

Main Results:

  • Open subpectoral biceps tenodesis is associated with reduced shoulder pain.
  • The procedure demonstrates a low rate of complications.
  • High patient satisfaction rates are reported following this surgical intervention.

Conclusions:

  • Open subpectoral biceps tenodesis is an effective surgical option for managing long head of the biceps tendon pathology.
  • The technique, when performed with attention to incision details and secure fixation, can yield favorable patient outcomes.
  • This approach offers a viable solution for patients with persistent shoulder pain refractory to conservative treatments.