Biceps Tendinitis: Arthroscopic Repair Technique With Anchors

Biceps Tendinitis: Arthroscopic Repair Technique With Anchors

This cadaveric surgical demonstration shows a biceps tendon repair called a tenodesis, in which the biceps tendon is cut from its normal attachment site at the shoulder socket and reattached elsewhere on the upper arm. This demonstration will show the repair completed arthroscopically using a camera and small instruments.

Here we have a right shoulder. The front of the patient is to the right of the screen, and the back of the patient is to the left of the screen. In the back of the shoulder, there is a camera called an arthroscope that allows the surgeon to see inside the shoulder joint. In the front of the shoulder, a purple tube called the cannula is placed. This will allow the surgeon to bring instruments in and out of the shoulder smoothly and safely.

Now, we are looking at the camera view from the back to the front of the shoulder joint. A metal instrument called a probe pulls on the biceps tendon to pull more of the tendon into the joint from the upper arm to look for any signs of inflammation. In this cadaveric specimen, we do not see any redness of the tissue, which would signal inflammation. Outside the shoulder, the surgeon is preparing the suture and loading it into a grasping tool. The surgeon will then introduce the suture into the shoulder and through a series of steps, will gain control of the biceps tendon.

Now that the biceps tendon is secured, the surgeon can cut the tendon from where it attaches at the socket of the shoulder. The surgeon then identifies a new spot to secure the biceps tendon to. In this procedure, it is right next to the cartilage surface of the ball of the shoulder joint, also known as the humeral head. A metal punch is brought in and hammered into the bone to create a pilot hole. Back outside the shoulder the suture that is secured to the biceps is loaded into an anchor, which looks similar to a screw.

The anchor and suture are then brought into the shoulder joint and into the pilot hole. The anchor and suture are placed, and the biceps tendon is now secure in its new location. A small cutting device is used to cut the excess suture and the procedure is now complete. Overtime, the biceps tendon will scar into its new position and relieve the tendinitis pain that was once felt.