Arthroscopic-Assisted Subpectoral Biceps Tenodesis for Symptomatic Biceps Tendon Disorder

Lesions of the long head of the biceps tendon have been recognized to be a common source of anterior shoulder pain and dysfunction. Common syndromes include primary biceps tendinitis, symptomatic biceps tendon subluxation, traumatic biceps tearing, coracoid impingement, and biceps tendinitis associated with either superior labrum anterior-to-posterior lesions or rotator cuff tears. The diagnosis is made on history of anterior shoulder pain, tenderness in the bicipital groove, and symptomatic relief of the pain with an injection of local anesthetic into the bicipital groove. MRI is not reliable in the diagnosis of biceps tendon disorders. When nonoperative treatment fails to relieve the symptoms of painful biceps tendinitis, biceps tenotomy or biceps tenodesis are often considered. In this chapter, we will review the pathology and anatomy of biceps tendon lesions, and the advantages of arthroscopic-assisted subpectoral biceps tenodesis. Excellent outcomes have been reported with this technique.