Biceps Tendon Repair

Michael Eckhoff, MD

Content Contributor

Evolution of Biceps Tendon Repair

Reattaching the biceps tendon to the arm bone in a tenodesis procedure can be done by several techniques including bone tunnels, interference screws, and suture anchors. These techniques are all performed through an open approach, meaning an additional incision on the upper arm to reattach the tendon.

The bone tunnel technique is done by drilling two holes in the bone, placing sutures through the tendon and bone to tie the tendon into place. Interference screws were later used to compress the tendon within the drill hole in the bone for increased fixation strength. However, as orthopedics advanced, sutures anchors were developed. Suture anchors were initially small metal screws with sutures attached to them that were then buried into the bone and the sutures were used to affix the tendon to the bone.

Suture anchors have allowed smaller incisions to be used to perform this technique. More recent versions of suture anchors act like barbs, where they allow insertion into the bone, but hooks prevent it from being pulled out. Newer suture anchors use all- suture systems, which allows for smaller implants and minimizing bone loss.

Technology Spotlight

Arthrex FiberTak™

Arthrex FiberTak™ is an all suture-based suture anchor that can be used to reattach the proximal biceps through a minimally invasive approach. All suture-based anchors provide rigid fixation with minimal bone loss that can come with other fixation. It can come with a single or double set of sutures attached to it.

The anchor is placed through a small hole drilled into the bone. As tension is pulled on the sutures, it expands a thickened area of the suture securing it in place and preventing it from coming back through the hole. The system is also designed to allow for easy tensioning of the tendon down to the bone by allowing some movement in the sutures prior to final tightening. This system is available for fixation of other soft tissues in the shoulder to include the labrum and in rotator cuff repairs.