Tensionable Knotless Tendon-Sparing Biceps Rerouting Technique for Irreparable Rotator Cuff Tears

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomedical Engineering

Background:

• Irreparable supraspinatus tears often necessitate advanced reconstructive techniques.
• Current methods may involve grafts or bone tunnels, posing risks and limitations.
• Preserving native tendon tissue is desirable for optimal biomechanical outcomes.

Purpose of the Study:

• To describe a novel, tensionable, knotless, tendon-sparing biceps rerouting technique.
• To utilize the long head of the biceps for superior capsular reconstruction.
• To provide biomechanical stability and functional improvement in patients with irreparable rotator cuff tears.

Main Methods:

• Arthroscopic release of the long head of the biceps from the bicipital groove.
• Rerouting the biceps tendon over the greater tuberosity footprint.
• Securing the tendon with knotless all-suture anchors and medial side-to-side sutures.

Main Results:

• The technique creates tensionable loops for stabilizing the biceps and remaining cuff.
• It avoids tendon perforation and eliminates the need for graft harvesting or bone tunnels.
• The approach is reproducible, minimally invasive, and suitable for degenerative or inflamed tendons.

Conclusions:

• This knotless biceps rerouting technique offers a viable, tendon-sparing solution for superior capsular reconstruction.
• It provides biomechanical stability and potential for improved functional outcomes.
• Careful patient selection is crucial for achieving optimal results.