The biceps tendon crosses the shoulder joint to attach to the superior aspect of the shoulder socket. It attaches both to the bone of the socket and the labrum (the fibrocartilage that deepens the socket to improve shoulder stability). In certain circumstances a tear can occur at this junction causing pain and loss of function in the shoulder. If this does not respond to non surgical management there are two options for treatment; labral repair or biceps tenodesis. From research conducted from the 1980's to present (mostly in throwing athletes), we know that as a patient gets older, the success of superior labral repair becomes less effective due to the labrum's reduced capacity to heal after surgery. Superior labral repair is generally considered in patients under the age of 40. Over the age of 40 an effective technique to relieve pain and restore function in the context of superior labral anterior to posterior tear is biceps tenodesis.
1: Hester WA, O'Brien MJ, Heard WMR, Savoie FH. Current Concepts in the Evaluation and Management of Type II Superior Labral Lesions of the Shoulder. Open Orthop J. 2018 Jul 31;12:331-341. doi: 10.2174/1874325001812010331. PMID: 30197715; PMCID: PMC6110065.
An arthroscopic biceps tendodesis can be performed to remove tension from the superior labrum by releasing the proximal biceps attachment and reattaching the tendon into the biceps groove on the proximal humerus.
A mini-open biceps tendodesis can be performed to remove tension from the superior labrum by releasing the proximal biceps attachment and reattaching the tendon into the biceps groove on proximal humerus.