In Situ Subpectoral Biceps Tenodesis With a Cortical Button

Abstract

The proximal portion of the long head of the biceps has become a recognized cause of significant shoulder pain. Tenodesis of the long head of the biceps has been advocated as treatment for pain resulting from biceps tendonopathy, biceps instability, and bicep tendon tears. Several techniques have been described for this tenodesis, including various arthroscopic and subpectoral methods. We present here a novel technique in which the biceps tendon is tenodesed in a subpectoral manner. Although subpectoral biceps tenodesis has been described before, the method described here allows for in situ fixation of the long head of the biceps tendon using a cortical button. This method allows for the fixation of the biceps at its resting length while causing minimal disruption of the cortex of the humerus. Illustrations, photos, and a detailed description of the technique are provided.