All-Arthroscopic Suprapectoral Biceps Tenodesis With Knotless Unicortical Locking Button Technique

Tenodesis of the long head of the biceps tendon is a well-established surgical procedure to treat isolated pathology of the proximal biceps as well as concomitant intra-articular glenohumeral pathology causing shoulder pain and dysfunction. Furthermore, multiple locations for the site of tenodesis and multiple implants for fixation have been described, all with overall similar outcomes and success rates. Potential advantages of an all-arthroscopic tenodesis include versatility in patient positioning, minimizing the need for additional incisions and efficiency while treating concomitant intra-articular pathology. We describe an all-arthroscopic suprapectoral biceps tenodesis technique utilizing a knotless locking button. This onlay technique provides a simple and efficient method that maintains the length-tension relationship of the proximal biceps.