Partial Rotator Cuff Repair With Biceps Rerouting and Double Tenodesis: An Efficient and Cost-Effective Biological Superior Capsular Reconstruction

Background: Chronic rotator cuff tears (RCTs) are common and often only partially repairable. Surgical treatment is challenging in younger patients. options include partial repair, tendon transfer, subacromial spacer, superior capsular reconstruction (SCR), reverse shoulder arthroplasty. The use of SCR has been expanded commercialized. proposed techniques complex using free avascular grafts up to 7 anchors with associated increase theater time nonrefunded cost. Biceps shown promising biomechanical resistance seems offer a simple cost-effective alternative. Indications: Patients RCTs (Goutallier stage ≥3, Patte 3) without arthritis that at least repairable (infraspinatus subscapularis) candidates. mechanically intact long head biceps (LHB) labrum anterior posterior (SLAP) anchor (minimal fraying <10% SLAP full-thickness acceptable) also Technique: Key steps arthroscopic release/lateral opening the bicipital grove (15-20 mm) placement first footprint 8 10 mm anatomical sulcus. Use 5-mm burr create new rerouting groove obliquely from original groove, 15 20 caudal summit tubercle. Lasso-loop translation tenodesis LHB anchor. second lasso-loops end groove. These 2 bipedicle performing function both an tenodesis. Single-row, tension-free over-the-top repair infraspinatus bursal layer supraspinatus completed third on rerouted which remains continuity. Results: pilot series (n = 10) mean follow-up 12 months (9-18 months) shows satisfactory outcomes. One patient developed postoperative frozen one secondary Popeye deformity. Functional scores satisfaction improved all cases. subjective value 30% (10%-40%) preoperatively 75% (60%-80%) postoperatively constant score 30 points (20-40) 68 (60-71). Conclusion: As as its adequate, combination safe alternative time-consuming expensive commercialized techniques.