Partial Rotator Cuff Repair With Biceps Rerouting and Double Tenodesis: An Efficient and Cost-Effective Biological Superior Capsular Reconstruction

Background: Chronic rotator cuff tears (RCTs) are common and are often only partially repairable. Surgical treatment is challenging in younger patients. Surgical options include partial repair, tendon transfer, subacromial spacer, superior capsular reconstruction (SCR), and reverse shoulder arthroplasty. The use of SCR has been expanded and commercialized. The proposed techniques are complex using free avascular grafts and up to 7 anchors with associated increase in theater time and nonrefunded cost. Biceps SCR has shown promising biomechanical resistance and seems to offer a simple and cost-effective alternative. Indications: Patients with RCTs (Goutallier stage ≥3, Patte 3) without arthritis that are at least partially repairable (infraspinatus and subscapularis) are candidates. Patients with mechanically intact long head of biceps (LHB) and superior labrum anterior to posterior (SLAP) anchor (minimal fraying of