Every arthroscopic surgeon must know an effective technique of treating injured tendon of the long head of biceps. Although tenotomy is the easiest technique to do, tenodesis is more suitable for some patients. Fxation to the sulcus can be proximal or subpectoral, and there are multiple anchoring methods to choose from. An ideal tenodesis is such that leads to a reliable healing of the tendon while not limiting rehabilitation.
These parameters are met by subpectoral biceps tenodesis with unicortical button fixation. The site of the tenodesis is located farther away from the joint and does not interfere with the intervention in the shoulder. Access via 2-cm incision in the interval between the pectoral muscle and biceps is cosmetically convenient and safe. The surgical field is clear and easily accessible. The entire procedure does not take more than 10 minutes and is easily done even at the end of the operation when the shoulder might already be slightly swollen.
Patients after subpectoral biceps tenodesis do not experience residual sulcus pain that is in some cases reported after proximal fixation. The fixation is sufficiently strong so that it allows the patient to exercise the shoulder without any limitations. This technique is well tolerated even by patients with extreme demands for the function of their shoulder – performance overhead athletes or surgeons. Welcome among biceps killers!