Alan M. Hirahara, MD, FRCSC
Orthopaedic SurgeonSpecialist in Sports Medicine

Ultrasound-guided Suprapectoral Tenodesis of the Long Head of the Biceps Brachii

Andersen WJ, Barcelos M, Raffaelli MP, Hirahara AM
Arthroscopy Techniques

November 20th 2020

When the long head of the biceps tendon is diseased, tenodesis is an appropriate
treatment strategy. The specific technique employed is dependent on visualization,
fixation method and hardware, and tenodesis location. For suprapectoral tenodesis
techniques, those that fix the tendon within or below the bicipital groove can be
challenging due to the transverse humeral ligament covering the groove. To accurately
identify the biceps tendon in this area, the ligament often requires resection.
Ultrasound provides surgeons with a safe and non-invasive tool to visualize the biceps
tendon as it exits the bicipital groove, negating the need for de-roofing and other pitfalls
associated with traditional techniques. This Technical Note describes an ultrasoundguided
suprapectoral biceps tenodesis procedure.