Biceps Tendinitis: Arthroscopic Repair in the Groove Technique Animation

Biceps Tendinitis: Arthroscopic Repair in the Groove Technique Animation

This animation will demonstrate a biceps tendon repair called a tenodesis, where the biceps tendon is cut from its normal attachment site at the shoulder socket and reattached elsewhere on the upper arm. Let us start with some review. There are a few different ways that a surgeon may choose to perform a biceps tenodesis. The tendon reattachment can be performed arthroscopically through small incisions, called portals, or by using a small open incision near the armpit.

When choosing an arthroscopic repair, the surgeon can reattach the tendon close to the shoulder joint or further down on the upper arm. In this animation, we will show the biceps tendon repair performed arthroscopically, specifically reattaching the tendon further down the arm in a bony groove called the bicipital groove. Here, we have a right shoulder. There are 2 purple tubes, called cannulas, placed into the shoulder. These cannulas will allow the surgeon to bring instruments into the shoulder to complete this procedure.

To begin, they will release the ligament that overlies the bicep tendon and then place a guide at this new location. Through the guide, they will drill a hole in preparation for a soft suture anchor. The anchor is placed into the bone through the guide and set into position. The anchor has sutures attached that will be used to secure the tendon to the bone. Through a series of steps, the blue and white solid sutures are wrapped around and through the tendon. Once the configuration is complete, it is time to secure the biceps down to the bone.

The end of the blue suture is loaded into the blue and white striped shuttle suture. The free end of the shuttle suture is pulled, bringing the solid blue suture down into a locking mechanism in the soft anchor body. The locking mechanism allows the surgeon to tighten the suture around the biceps by pulling the free end without the need to tie knots to hold the tension. The other free end of the white loop is already secure within the anchors locking mechanism. The surgeon can then alternate pulling the free end of the white suture and blue suture to secure the biceps tendon to the bone.

The surgeon will then cut the biceps tendon just above its new attachment site and at its original attachment site at the shoulder socket, and remove the damaged portion from the shoulder joint. The procedure is now complete.