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Mini-Open Subpectoral Biceps Tenodesis With an Onlay Knotless TensionTight Locking Button Technique
Mikalyn T DeFoor1, Michael G Rizzo2,3, Marco Adriani2,4
1San Antonio Military Medical Center, Fort Sam Houston, Texas, U.S.A.
Arthroscopy Techniques
|June 23, 2025
Summary
Isolated long head of the biceps (LHB) pathology often accompanies other shoulder issues. This study details a knotless onlay technique for LHB tendon repair, offering advantages over traditional methods.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Shoulder Arthroscopy
Background:
- Long head of the biceps (LHB) pathology, though rare in isolation, frequently coexists with intra-articular shoulder conditions like subscapularis and SLAP tears.
- Shoulder pain related to the LHB often stems from repetitive overhead activities and resisted forearm movements.
Purpose of the Study:
- To present a preferred surgical technique for treating long head of the biceps tendon pathology.
- To highlight the benefits of an all-knotless onlay fixation method.
Main Methods:
- Description of a mini-open subpectoral biceps tenodesis procedure.
- Utilizing an all-knotless onlay TensionTight locking button technique for LHB tendon fixation.
Main Results:
- The onlay technique secures the tendon to the cortical surface, reducing risks of torsional fracture and minimizing bone loss compared to intraosseous fixation.
- This method offers a smaller footprint for fixation.
Conclusions:
- The described knotless onlay technique provides an effective and advantageous approach for managing long head of the biceps tendon pathology.
- This technique may offer improved outcomes and reduced complications in shoulder surgery.
