Arthroscopic Rotator Cuff Repair With Autologous Biologic Augmentation Using Biceps Tendon Redirection and Incorporation

The long head of the biceps tendon is a valuable autologous tissue for biologic augmentation in rotator cuff repair. Redirecting the long head of the biceps tendon can enhance its role as a humeral head depressor, limiting superior humeral head migration, and improving rotator cuff force couple and shoulder biomechanics. Incorporating the long head of the biceps tendon into the rotator cuff repair construct can enhance the repair by acting as a biologic internal brace, promoting load sharing and improving structural integrity. This technique may improve healing, repair durability, and functional outcomes, especially in large or revision tears with poor tissue quality.