Long head of the biceps tendon pathology is a well-described proximal shoulder pain generator. While optimal treatment strategy remains controversial, popular operative management includes biceps tenodesis. However, appropriate restoration of the anatomic length–tension relationship of the biceps with tenodesis remains a challenge. We aim to describe a patient-specific technique utilizing a mini-open subpectoral approach to mark the long head of the biceps myotendinous junction location within the intertubercular groove prior to arthroscopic origin tenotomy. This technique offers the ability to restore anatomic tensioning of the long head of the biceps without relying on variable anatomic relationships, additional portals, tools, or technical challenges.
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