Arthroscopic Suture-Only Intra-articular Soft-Tissue Long-Head Biceps Tenodesis to the Rotator Cuff

Pathology of the long head of the biceps tendon (LHBT) is a prevalent source of shoulder pain and is often concomitant with rotator cuff diseases. Various treatment modalities exist for addressing this condition, including surgical approaches, anatomical sites for tenodesis fixation, and types of fixation devices employed. We describe an arthroscopic suture-only intra-articular soft-tissue long-head biceps tenodesis to the rotator cuff technique for managing LHBT pathology using a loop-and-tack configuration with suture shuttling to secure the LHBT to the anterior supraspinatus without anchors. This technique maintains the physiological length-tension relation, mitigates implant-related complications, and offers a cost-effective solution for treating LHBT pathology.