This narrative review covers the indications, surgical techniques, and clinical outcomes of tenodesis of the long head of the biceps. It compares tenodesis with tenotomy and contrasts open subpectoral versus arthroscopic approaches. It also reviews fixation methods and their reported results.
When a patient fails conservative treatment for long head of the biceps pathology, the decision between tenotomy and tenodesis hinges mostly on cosmesis and demand, not pain relief. Both relieve pain reliably. Reserve tenotomy for lower-demand patients over 55 to 60 who will accept a possible Popeye deformity, and choose tenodesis for younger persons, athletes, and laborers.
A high-yield decision rule: for isolated type-II SLAP lesions, tenodesis gives far better return to sport (87% vs 20%) than labral repair and salvages failed repairs. The biggest procedural pitfall is the medial neurovascular structures during open subpectoral fixation. Careful medial retraction with a Chandler retractor prevents catastrophic median and musculocutaneous nerve injury.
Understand the Snyder classification (Type IV = tear extending into the biceps tendon) and the peel-back mechanism for board questions.
This narrative review covers the indications, surgical techniques, and clinical outcomes of tenodesis of the long head of the biceps. It compares tenodesis with tenotomy and contrasts open subpectoral versus arthroscopic approaches. It also reviews fixation methods and their reported results.
When a patient fails conservative treatment for long head of the biceps pathology, the decision between tenotomy and tenodesis hinges mostly on cosmesis and demand, not pain relief. Both relieve pain reliably. Reserve tenotomy for lower-demand patients over 55 to 60 who will accept a possible Popeye deformity, and choose tenodesis for younger persons, athletes, and laborers.
A high-yield decision rule: for isolated type-II SLAP lesions, tenodesis gives far better return to sport (87% vs 20%) than labral repair and salvages failed repairs. The biggest procedural pitfall is the medial neurovascular structures during open subpectoral fixation. Careful medial retraction with a Chandler retractor prevents catastrophic median and musculocutaneous nerve injury.
Understand the Snyder classification (Type IV = tear extending into the biceps tendon) and the peel-back mechanism for board questions.