A Simple, All-Arthroscopic, Knotless Suture Lasso Loop Technique for Suprapectoral Biceps Tenodesis

Abstract

A variety of pathology of the long head of the biceps tendon can contribute to anterior shoulder pain in adults that can be managed with either arthroscopic tenotomy or tenodesis when conservative treatment fails. Biceps deformity or the Popeye sign is a major concern in patients after tenotomy. Biceps tenodesis can be performed in a variety of ways with different sized anchors and at different locations (suprapectoral or subpectoral). Several studies have shown that patient outcomes and complication rates are similar between all-arthroscopic suprapectoral biceps tenodesis and open subpectoral biceps tenodesis. We describe a simple, knotless, arthroscopic intra-articular biceps tenodesis technique using a 1.5-mm LabralTape lasso loop technique and a 2.9-mm PushLock anchor.S urgical intervention for pathology of the long head of the biceps has been well established in the literature. Although simple biceps tenotomy may yield good results, biceps tenodesis may offer increased patient satisfaction and a lower incidence of undesirable Popeye deformity and biceps cramping.

Modified Arthroscopic Double-Row Technique for Isolated Biceps Tenodesis

“…For example, keyhole xation may fail due to low primary stability [34], knot pullout [35], and excess tension [36]. The interference screw technique may lead to screw loosening [37] and tendon concis [32] because of proximal cancellous bone and tendon-bone extrusion [32], and the length-tension relationship is di cult to control with this technique [38,39]. The traditional single anchor xation technique may not offer adequate stabilization of the tendon, and the construct strength may be poor.…”

Arthroscopic Subscapularis Repair Using a Clever Hook and Lasso Loop Technique in the Beach Chair Position: A Simple and Reproducible Guide

“…See technique by Saper and Li. 17 Both the technique we described here for subscapularis tendon repair and the knotless suture lasso technique for suprapectoral biceps tenodesis use the same anterior and ASL working portals. Next, to better define the subscapularis tear and evaluate its excursion, using an arthroscopic shaver and radiofrequency device, define the tendon and mobilize it from the surrounding capsule.…”

“…Biceps pathology is addressed first, as it is commonly seen with both acute and chronic subscapularis tears. Saper and Li 17 previously described an all-arthroscopic knotless suture lasso technique for suprapectoral biceps tenodesis. This technique allows for both biceps and subscapularis pathology to be addressed through the same 2 portals anteriorly.…”

Diagnosis and Treatment of Injuries to the Biceps and Superior Labral Complex in Overhead Athletes

“…The biceps tendon can be tensioned and fixed to the proximal humerus using a variety of arthroscopic or open techniques. Arthroscopic suprapectoral biceps tenodesis can be performed with a suture anchor [57], interference screw [58], or can be a soft tissue repair in the case of a biceps tendon transfer [59,60].…”