Biceps Transfer Using Subdeltoid Arthroscopy

Abstract

| ABSTRACT The diagnosis and treatment of biceps tendon pathology remain controversial. These patients may be more resistant to conservative treatment than those patients with standard subacromial impingement. When conser- vative treatment fails, surgical options should be explored. Tenotomy and tenodesis of the biceps tendon have been described, although persistent pain, deform- ity, and muscle cramping have been frequently reported. We describe a novel technique of biceps tenodesis by arthroscopic transfer of the long head of the biceps tendon to the anterior aspect of the lateral conjoint tendon using the subdeltoid space. The soft tissue transfer closely reproduces the native axis of pull of the biceps. It also allows soft tissue healing, which creates the normal ''bungee^ effect of the superior labrum/biceps anchor complex. This technique also allows the surgeon direct visualization during tenodesis to help prevent overtensioning of the tendon. Because of the early success of the procedure, we continue to use this technique with increasing frequency in appropriately indicated patients to access the anterior aspect of the shoulder extraarticularly.