Intra-articular Proximal Biceps Tenotomy With Extra-articular Transfer: A Technique to Repair Full-thickness Rotator...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder Arthroscopy

Background:

• The long head of the biceps tendon (LHBT) is anatomically positioned near the rotator cuff, making it a potential graft source for repairs.
• Current LHBT surgical techniques, such as tenotomy or fixation, have limitations including potential pain, deformity, and tissue wastage.
• Biceps tendon transfer techniques aim to maximize the utility of available tendinous tissues for improved shoulder function.

Purpose of the Study:

• To describe a novel arthroscopic intra-articular proximal biceps tenotomy with extra-articular transfer procedure.
• To evaluate the potential benefits of this technique, including a "latch effect" and rotator cuff strengthening.
• To assess the technique's potential to reduce rotator cuff retear rates.

Main Methods:

• The procedure involves an arthroscopic approach to perform a proximal tenotomy of the LHBT within the joint.
• The detached LHBT is then transferred and secured outside the joint capsule (extra-articular).
• This technique leverages the LHBT for augmentation of rotator cuff integrity.

Main Results:

• The described technique creates a "latch effect", potentially improving shoulder stability.
• Transfer of the LHBT serves to augment and strengthen the adjacent rotator cuff tendons.
• Preliminary findings suggest this method may contribute to a reduced incidence of rotator cuff retears.

Conclusions:

• Arthroscopic intra-articular proximal biceps tenotomy with extra-articular transfer is a viable surgical option for specific rotator cuff injuries.
• This technique offers potential advantages in enhancing rotator cuff strength and possibly lowering retear rates.
• Further studies are warranted to fully elucidate the long-term efficacy and outcomes of this procedure.