The "Sandwich Tenodesis": An Arthroscopic Technic for Combined Soft-Tissue and Bony Fixation of the Long Head of the Biceps

Romain Chevallier; Miche Calo; Uma Srikumaran; Suresh Nayar; Geoffroy Nourissat

doi:10.1016/j.eats.2020.10.040

The "Sandwich Tenodesis": An Arthroscopic Technic for Combined Soft-Tissue and Bony Fixation of the Long Head of the Biceps

Arthrosc Tech. 2021 Jan 16;10(2):e555-e559. doi: 10.1016/j.eats.2020.10.040. eCollection 2021 Feb.

Authors

Romain Chevallier¹, Miche Calo², Uma Srikumaran³, Suresh Nayar³, Geoffroy Nourissat¹

Affiliations

¹ Clinique Maussins Nollet, Paris, France.
² Orthopaedics and Traumatology Department, Ospedale San Luigi Gonzaga, Orbassano, Italy.
³ John Hopkins Orthopaedic Surgery, Howard County General Hospital, Baltimore, Maryland, U.S.A.

Abstract

Pathology of the long head of the biceps can contribute to substantial shoulder pain. After nonoperative treatment has failed, either open or arthroscopic tenotomy or tenodesis can be recommended depending on age, occupation, function, and cosmetic preference. While classic tenodesis techniques rely on tendon-to-bone fixation, multiple studies have shown superior healing results for fixation between similar types of tissue, such as tendon-to-tendon. In this technique, we present the "sandwich technique," performed entirely arthroscopically. A single 4-strand anchor with bioabsorbable screw is used to provide 2 types of fixation. Two strands are first used to lasso-loop the long head of the biceps to the bicipital groove, providing bone-to-tendon fixation. The other strands are then used to anchor rotator interval tissue to the tendon, providing a similar tissue or tendon-to-tendon patch augmentation.