Dynamic Biceps Rerouting for Irreparable Posterior-Superior Rotator Cuff Tear

Irreparable posterior-superior rotator cuff tear (IPSRCT) is a common clinical condition. Many methods of transfer of the long head of the biceps (LHB) have been developed to augment the shoulder superiorly, with the best method using the LHB still being pursued. In this article, we introduce a special method using the LHB to address IPSRCT: arthroscopic dynamic LHB rerouting. The main steps of this technique include opening the native bicipital groove, creating a new bicipital groove through the greater tuberosity, rerouting the LHB into the new bicipital groove without LHB fixation, and side-to-side rotator cuff repair over the LHB. Our clinical experience indicates this technique can be easily and safely performed according to certain guidelines. We think the introduction of this technique will bring special insight to superior shoulder augmentation in case of IPSRCT.