Applications for the Biceps Tendon in Rotator Cuff Repair

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder Arthroscopy

Background:

• The long head of the biceps tendon was historically overlooked in shoulder arthroscopy.
• Recent advancements recognize its potential as a robust autograft for reconstructive procedures.

Purpose of the Study:

• To present various augmentation and reconstruction techniques utilizing the long head of the biceps tendon in shoulder arthroscopy.
• To highlight the utility of biceps autograft in managing complex rotator cuff tears.

Main Methods:

• Mobilization and transposition of the intact biceps tendon for intertendinous augmentation (superior capsular reconstruction).
• Tenotomy and use of the proximal biceps tendon for anterior cable reconstruction.
• Release and redirection of the biceps tendon for insertional augmentation ('sandwich' technique).
• Arthroscopic routing of the biceps tendon for massive irreparable tears ('snake' technique).
• Harvesting and processing the biceps tendon for autograft patch augmentation ('biceps smash').
• Supplementation of subscapularis repairs using the biceps tendon.

Main Results:

• Demonstrated feasibility of multiple biceps autograft techniques for diverse rotator cuff pathologies.
• Showcased the biceps tendon's role in augmenting repairs, reconstructing deficient structures, and managing irreparable tears.
• Highlighted the 'biceps smash' technique as an alternative to biologic patches.

Conclusions:

• The long head of the biceps tendon is a valuable and adaptable autograft in shoulder arthroscopy.
• These techniques provide surgeons with expanded options for treating complex rotator cuff tears.
• Biceps autograft procedures offer effective solutions for augmentation and reconstruction, improving patient outcomes.