Inlay Dynamic Anterior Stabilization of the Shoulder With Long Head Biceps Tendon Using All-Suture Anchor

Dynamic anterior stabilization using the long head of the biceps tendon (LHBT) has emerged as a soft-tissue alternative for treating anterior shoulder instability in the setting of subcritical glenoid bone loss. This Technical Note describes an inlay dynamic anterior stabilization technique using soft-tissue anchors designed to enhance tendon-to-bone healing and optimize the length-tension relation of the transferred LHBT. The procedure combines a modified Bankart repair with trans-subscapularis LHBT transfer and fixation within a 5-mm anterior-inferior glenoid bone tunnel using inlay soft anchors and Krakow suturing. This construct reproduces sling and hammock stabilizing effects while preserving external rotation and avoiding bone grafting. The technique allows intraoperative adaptability when labral tissue is inadequate for isolated Bankart repair and does not preclude future bone-block procedures if required. Inlay dynamic anterior stabilization with LHBT is a reproducible and cost-effective option for selected patients with anterior instability and glenoid bone loss less than 20%.