[Arthroscopic suprapectoral tenodesis of the long head of the biceps tendon].

OBJECTIVE: The aim of a tenotomy of the long biceps tendon is to remedy a painful pathology in the proximal region of the tendon. Tenodesis of the tendon can restore the motor and cosmetic function of the biceps brachii muscle.

INDICATIONS: Partial rupture or tendopathy of the long biceps tendon, injuries of the anchor of the long biceps tendon (SLAP lesions; SLAP: superior labrum anterior posterior), lesions of the pulley system.

CONTRAINDICATIONS: Infections or tumors, loss of the long head biceps tendon from the intertubercular groove.

SURGICAL TECHNIQUE: Shoulder arthroscopy via a posterior standard portal in beach chair position. Anteroinferior portal. Standard diagnostic arthroscopy. Checking the stability of the biceps anchor and the pulley system with a probe. Testing the extra-articular portion of the long biceps tendon with the hook. By pulling the tendon into the joint, the course of the tendon can be assessed. Anterolateral portal superior of the intertubercular groove. Pulling the tendon out of the anterolateral portal. Arming of the tendon with Krackow stitches. Fixation of the tendon in the intertubercle groove with a knotless suture anchor.

POSTOPERATIVE MANAGEMENT: Three weeks immobilization with an arm sling, 6 weeks no forced elbow flexion and forearm supination, 2 weeks active-assisted mobilization of the shoulder up to horizontal, 30° external rotation, internal rotation free.

RESULTS: The results published in the literature show that epiossal anchor tenodisis improves the clinical scores (preoperative vs. postoperative) and leads to a better cosmetic result and a lower rerupture rate than soft tissue tenodesis.