The Gripping Biceps Knot: All-Arthroscopic Self-Cinching Knot for Proximal Biceps Tenodesis

Lesions involving the long head of the biceps tendon are a frequent source of anterior shoulder pain and often coexist with other shoulder pathologies such as rotator cuff or labral tears. Although biceps tenodesis has emerged as a preferred treatment over tenotomy-particularly in younger, active individuals-tissue pullout at the suture-tendon interface remains a critical failure point in various fixation methods. This Technical Note introduces the gripping biceps knot, an adaptation of the gripping sailor's hitch, designed to enhance suture-tendon fixation through a self-cinching, intratendon configuration. Our all-arthroscopic technique provides a safe, efficient, and effective approach to improving biomechanical integrity and reducing the risk of repair failures in proximal biceps tenodesis.