Mini-Open Subpectoral Biceps Tenodesis With an All-Suture Anchor

The long head of the biceps tendon can be a source of pain in a variety of shoulder pathogies such as including biceps tenosynovitis, type II SLAP tears, partial long head of the biceps tears, and long head of the biceps subluxations or dislocations among others. When nonoperative management has failed and surgical management is indicated, the long head of the biceps can be treated with either tenotomy or tenodesis. Although tenotomy is reliably effective, tenodesis is often preferred as it helps prevent complications such as cramping, fatigue, and supination and elbow flexion weakness. Several biceps tenodesis techniques have been described including suprapectoral vs subpectoral, open vs arthroscopic and a variety of fixation methods have been used including a biotenodesis screw, cortical button, bone bridge, and suture anchor. This article describes the technique for a mini-open, subpectoral on-lay biceps tenodesis using an all-suture anchor double loaded with suture tape. We prefer this method as it provides effective fixation with minimal tendon slippage and minimizes the risk of complication.