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Optimizing Length-Tension Relationship Using Unicortical Button Fixation for Subpectoral Biceps Tenodesis

Many techniques for tenodesis of the long head of the biceps tendon have been described in the orthopedic literature. However, few focus on restoring the native length-tension relationship of each patient’s individual anatomy and instead recommend fixing the tendon based on predetermined anatomic landmarks. We present a method of biceps tenodesis using a unicortical button, which allows for anatomic tensioning and dynamic adjustment of the tension by the surgeon based on intraoperative observation.