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Dr. Garcia demonstrates his arthroscopic biceps tenodesis in the lateral position.
Dr. Garcia specializes in complex knee, shoulder and elbow sports surgeries. He has prepared a number of surgical videos below to help patients better understand their procedures. He is frequently updating his surgical video database so check back soon for further updates.
This video demonstrates Dr. Grant Garcia's advanced technique for a distal biceps tendon repair using an endobutton (cortical button) construct. This surgical procedure is indicated for patients who have suffered a complete rupture of the distal biceps tendon at its insertion point on the radial tuberosity in the forearm.
The reconstruction focuses on securely reattaching the retracted tendon back to the bone to fully restore forearm supination and elbow flexion strength.
The procedure is outlined through the following key steps:
- Tendon Isolation and Preparation: A small, minimally invasive incision is made over the anterior aspect of the elbow. Dr. Garcia locates the ruptured, retracted distal biceps tendon and delivers it through the incision. The diseased or frayed end of the tendon is debrided, and a high-strength suture configuration (such as a Krakow or baseball stitch) is run up the tendon tail to secure it tightly to the cortical button.
- Exposing the Radial Tuberosity: Blunt dissection is utilized to navigate safely past vital neurovascular structures (like the radial nerve) to expose the raw anatomical footprint at the radial tuberosity.
- Drilling the Bone Tunnel: Using a specialized drill guide, Dr. Garcia drills a small guide tunnel directly through both cortices of the radius bone at the native tuberosity site. The near cortex is then reamed to a larger diameter that perfectly matches the thickness of the prepared biceps tendon.
- Button Deployment and Cinching: The metal endobutton, pre-loaded with the tendon sutures, is passed completely through the bone tunnel using a switching stick or shuttle wire. Once it exits the far side of the bone cortex, the button is flipped and deployed flat against the outer wall of the radius, anchoring itself securely.
- Tendon Drawing and Lock: The trailing sutures are tensioned, drawing the whipped end of the biceps tendon directly down into the reamed bone socket. The construct is then tied or locked down flush, achieving rigid, stable bone-to-tendon compression.
The final evaluation demonstrates excellent structural tension and mechanical hold, providing a robust, low-profile fixation that permits early, accelerated post-operative rehabilitation for an optimal functional recovery.
