AANA Lab Course 1002 -3rd Annual Fellows/Chief Residents-Biceps Tenodesis Indications and Technique (Intra-articular, Suprapec, Subpec)-Timothy S. Leroux, M.D.

Biceps Tenodesis Indications and Technique (Intra-articular, Suprapec, Subpec)-Timothy S. Leroux, M.D.

Pdf Summary

This document by Dr. Timothy Leroux discusses techniques for biceps tenodesis, a surgical procedure addressing issues with the biceps tendon. Indications include isolated biceps tenosynovitis or tears (rare), management of SLAP tears (more common), and coexisting rotator cuff pathology (most common). There are multiple options regarding the location (suprapectoral vs. subpectoral) and method (open vs. arthroscopic) of the procedure, as well as fixation techniques (onlay vs. inlay, using anchors, buttons, screws).<br /><br />Dr. Leroux prefers open subpectoral tenodesis with inlay anchor fixation, especially for younger, athletic, or muscular patients, which accounts for about 70% of his cases. For older or more sedentary patients, he opts for arthroscopic suprapectoral tenodesis using onlay anchor fixation.<br /><br />Key considerations include proper tensioning to recreate the anatomic length-tension relationship of the biceps tendon. The open technique carries a slightly higher complication rate (~2%) including risks like infection, humeral fractures, and nerve injury, but failure rates are similar between techniques. Rehabilitation generally involves avoidance of active elbow flexion for six weeks post-surgery.<br /><br />Regarding outcomes and evidence, Dr. Leroux stresses there is no definitive superiority between techniques. His recommendation is to choose and master the technique one is most familiar and skilled with to ensure the best results.<br /><br />In summary, biceps tenodesis can be performed successfully via different approaches tailored to patient characteristics, with careful attention to technique and rehab protocols to optimize outcomes.

Keywords

biceps tenodesis

biceps tendon

tenosynovitis

SLAP tears

rotator cuff pathology

open subpectoral technique

arthroscopic suprapectoral technique

anchor fixation

surgical complications

rehabilitation protocols