Short-term Outcomes of a Loop and Tack Intra-articular Long Head of Biceps Tenodesis

Abstract Background: Pathology of the long head of the biceps tendon (LHBT) is commonly encountered in patients undergoing shoulder arthroscopy, often in association with rotator cuff tears. Tenodesis has been shown to reduce cosmetic deformity and preserve supination strength compared to tenotomy, with several arthroscopic techniques described. The loop-and-tack intra-articular tenodesis is a simple, reproducible method with promising biomechanical characteristics, but limited clinical outcome data are available. Aim: The aim of this study was to evaluate the short-term clinical outcomes of the loop-and-tack LHBT tenodesis technique. Methods: A cross-sectional study was performed, including 45 patients (31 female, 14 male; mean age 57 years) who underwent arthroscopic loop-and-tack LHBT tenodesis with a minimum follow-up of 3 months (mean 26 weeks). Outcomes included patient-reported pain using a Visual Analog Scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, subjective weakness, Popeye deformity, and sonographic confirmation of LHBT position. Results were compared to published outcomes by Belay et al . Results: Mean ASES was 75.6 (standard deviation 12.5) and median VAS was 1.2 (interquartile range 0–2). Compared to Belay et al ., patients had significantly lower pain (VAS 1.2 vs. 4.6, P < 0.001) and higher ASES scores (75.6 vs. 59.4, P < 0.001). More than half (53.3%) reported some pain, although typically mild, and 86.7% had persistence of the tendon in the bicipital groove on ultrasound. Popeye deformity was rare (11.1%) and did not affect functional scores. ASES was significantly lower in patients reporting pain, weakness, or tenderness over the groove. Conclusion: The loop-and-tack intra-articular LHBT tenodesis provides favorable short-term outcomes with low pain, high functional recovery, and a low rate of cosmetic deformity. Persistence of the tendon in the groove was common but did not appear to compromise clinical results. This technique is a reliable, reproducible arthroscopic option; however, larger studies with long-term follow-up are warranted to confirm these findings.