The knowledge of the biceps tendon as a potential source of pain in the shoulder has been longstanding. However, the diagnosis and treatment of biceps tendon pathology still remains controversial. Conservative management includes activity modification, physical therapy, local steroid injections, and oral anti-inflammatory medications. Although reports of the results of conservative management are limited, patients with a component of biceps tenosynovitis may be more resistant to treatment than standard sub- acromial impingement. Furthermore, patients with mechanical symptoms caused by biceps pathology rarely respond to conservative treatment.
When conservative management fails, surgical options include tenotomy or tenodesis. Recently, tenotomy has been reported to provide reliable pain relief, but complications including cosmetic deformity and muscle spasm are common in younger patients.2-4 In terms of tenodesis, reports in the literature of the use of contemporary techniques are limited. However, earlier reports have indicated a fairly high failure rate, especially when tenodesis is performed without concomitant subacromial decompression. More recently, the senior author (S.J.O.) has developed an arthroscopic technique for transfer of the long head biceps tendon to the conjoint tendon as a method of tenodesis.
This study hypothesized that an all-arthroscopic technique for transfer of the long-head biceps to the conjoint tendon instead of traditional tenodesis transfer more closely recreates the normal axis of the biceps muscle and may offer improved results over conventional tenodesis.