Arthroscopic Suprapectoral Tenodesis of the Long Head Biceps: Reproducing an Anatomic Length-Tension Relationship Tal S. David, M.D., Jeffrey C. Schildhorn,

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Arthroscopic Suprapectoral Tenodesis of the Long Head Biceps: Reproducing an Anatomic Length-Tension Relationship Tal S. David, M.D., Jeffrey C. Schildhorn, M.D. Arthroscopy Techniques Volume 1, Issue 1, Pages e127-e132 (September 2012) DOI: 10.1016/j.eats.2012.05.004 Copyright © 2012 Arthroscopy Association of North America Terms and Conditions

Figure 1 LHB tendon with a longitudinal split tear within the biceps groove in a left shoulder viewed from the standard posterior portal. This lesion was not identified until the tendon was pulled into the glenohumeral joint. Arthroscopy Techniques 2012 1, e127-e132DOI: (10.1016/j.eats.2012.05.004) Copyright © 2012 Arthroscopy Association of North America Terms and Conditions

Figure 2 LHB tendon stabilized with a spinal needle before release with electrocautery in a right shoulder viewed from the standard posterior portal. Arthroscopy Techniques 2012 1, e127-e132DOI: (10.1016/j.eats.2012.05.004) Copyright © 2012 Arthroscopy Association of North America Terms and Conditions

Figure 3 The surgeon's right hand is directing the arthroscope through the viewing portal parallel to the long axis of the humerus in a left shoulder in the lateral decubitus position. The surgeon's left hand is controlling electrocautery through the working (transdeltoid) portal. Arthroscopy Techniques 2012 1, e127-e132DOI: (10.1016/j.eats.2012.05.004) Copyright © 2012 Arthroscopy Association of North America Terms and Conditions

Figure 4 (A) Proximal-to-distal view of falciform ligament in a right shoulder, with the arthroscope through the accessory anterolateral portal, viewing distal within the subdeltoid bursae. The intersection between the longitudinal fibers of the biceps sheath and the transverse fibers of the superior edge of the pectoralis major should be noted. (B) Close-up view of intersecting fibers that make up falciform ligament. The LHB lies just beneath this visual landmark. Arthroscopy Techniques 2012 1, e127-e132DOI: (10.1016/j.eats.2012.05.004) Copyright © 2012 Arthroscopy Association of North America Terms and Conditions