Arthroscopic Biceps Tenodesis: Direct Suturing and Results

The long head of the biceps is a common cause of shoulder pain. Arthroscopic biceps tenodesis can be combined with treatment to the rotator cuff and impingement. Certain superior labrum anterior-posterior (ie, SLAP) tears in nonthrowing athletes may be treated with a tenodesis. The direct suture repair to the supraspinatus can provide biceps tendon stability and relief of pain. A series of 48 patients with direct suture repair are presented. Most patients had biceps partial tears and instability, but some were treated for SLAP tears or revision surgery for capsular contracture and rotator interval scarring. Patients with partial-thickness rotator cuff tears had reinforcement of the tears with the biceps. Patients with subscapularis or supraspinatus tears had biceps tenodesis placed superiorly or posteriorly to the tear. Pain relief was predictable, stiffness was uncommon, and most patients returned to an active lifestyle without pain along the intertubercular groove.