Disorders of the long head of the biceps: tenotomy versus tenodesis

Ribeiro, Fabiano Rebouças; Ursolino, André Petry Sandoval; Ramos, Vinicius Ferreira Lima; Takesian, Fernando Hovaguim; Júnior, Antonio Carlos Tenor; Costa, Miguel Pereira da

doi:10.1016/j.rboe.2017.04.001

Cited by 4 publications

(4 citation statements)

References 54 publications

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“…Hitchcock and Bechtol found that the bicipital groove is shallow with a medial wall angle less than 45° in 8% of patients, and they believed that this corresponded with Meyer’s observation of a medial LHB tendon dislocation in 8% of his cadavers. 16 , 17 This finding was also supported by Lafosse et al. who stated that a decreased lesser tuberosity angle can facilitate medial subluxation or dislocation of the LHB tendon.…”

Section: Discussionmentioning

confidence: 57%

A rare case of an anatomical variation of bilateral long head of the biceps brachii tendons identified within the substance of bifid subscapularis tendons

Ayoubi

Darwish

Nassour

et al. 2021

Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilit

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The long head of the biceps tendon is stabilized in the intertubercular groove by several anatomical structures. Dislocation or identification of the biceps tendon into or within the subscapularis tendon is very rarely mentioned in the literature. This is the first reported case of bilateral identification of the long head of the biceps tendons within the lateral subscapularis tendon. This report presents the case of a 51-year-old male patient who presented for bilateral shoulder pain. After failure of conservative treatment, MRIs were done which identified bilateral biceps tendons within the subscapularis tendons, with a concomitant supraspinatus tear on the right side. He underwent right shoulder arthroscopic biceps tenotomy, with supraspinatus repair. The symptoms of the left shoulder diminished as a result of the continuation of conservative treatment. The long head of the biceps tendon normally travels through the intertubercular groove and is stabilized by soft tissue and bony structures. Medial dislocation of the tendon is affected by the medial wall angle and by the integrity of the soft tissue stabilizers; most importantly the coracohumeral ligament in the proximal part of the groove. Dislocation of the biceps tendon into the substance of the subscapularis has been rarely mentioned in the literature; and as far as we know, bilateral occurrence without any identifiable subscapularis tears has never been previously mentioned. The bilateral occurrence with the absence of subscapularis lesions indicates that this is a congenital anomaly.

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Section: Discussionmentioning

confidence: 57%

A rare case of an anatomical variation of bilateral long head of the biceps brachii tendons identified within the substance of bifid subscapularis tendons

Ayoubi

Darwish

Nassour

et al. 2021

Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilit

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show abstract

“…Recent evidence and reviews have not shown a significant difference in strength and outcomes when comparing tenodesis versus tenotomy; however, there have been reports of higher rates of Popeye deformity after tenotomy. 5 , 9 , 10 , 18 , 19 According to Galdi et al, 7 patients have strong preferences for which procedure they undergo. Significant patient concerns are the fear of cosmetic (Popeye) deformities, continued pain, dysfunction in strength or endurance, and recovery time.…”

Section: Discussionmentioning

confidence: 99%

Trends in the Treatment of Biceps Pathology: An Analysis of the American Board of Orthopaedic Surgery Database

Belk

Jones

Thon

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Long head of biceps tendon pathology is a well-described source of pain in the anterior adult shoulder. Shoulder arthroscopic surgeons face this condition on a frequent basis because of the increasing aging population. Trends in treatment for this condition have varied over recent decades. An understanding of these trends may help orthopaedic surgeons counsel these patients. Purpose: To evaluate trends in treatment selection, patient population, and complications in recent part II examinees of the American Board of Orthopaedic Surgery (ABOS) board examination. Study Design: Cross-sectional study. Methods: Using a database maintained by the ABOS, we accessed and analyzed examinee data from 2008 to 2019 to evaluate trends in the following categories: examination year/subspecialty, region, patient age/sex, International Classification of Diseases code, Current Procedural Terminology code, and complications. These data points were analyzed for all board-eligible candidates from 2008 to 2019. Results: The annual number of proximal biceps tendon (PBT) procedures performed increased significantly from 597 cases in 2008 to 2203 cases in 2019 ( P < .001). Incidence of biceps tendon tenotomy significantly decreased between the years 2007 and 2018 ( P < .001). Both open and arthroscopic biceps tenodesis significantly increased between 2007 and 2018 ( P < .001). Most PBT cases were performed simultaneously with other procedures (17,283/17,861; 96.8%). The most common PBT procedure performed overall was open tenodesis of long tendon of biceps (∼60.8%). Complication rates for PBT procedures reported each year did not significantly change between 2007 and 2018 (7.5% vs 9.7%; P = .103). Conclusion: PBT procedures are being increasingly performed among recently trained orthopaedic surgeons. Proximal biceps tenotomy has significantly declined, whereas proximal biceps tenodesis, open or arthroscopic, has significantly increased, demonstrating a possible shift in the standard of care among new surgeons.

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“…For example, keyhole xation may fail due to low primary stability [34], knot pullout [35], and excess tension [36]. The interference screw technique may lead to screw loosening [37] and tendon concis [32] because of proximal cancellous bone and tendon-bone extrusion [32], and the length-tension relationship is di cult to control with this technique [38,39]. The traditional single anchor xation technique may not offer adequate stabilization of the tendon, and the construct strength may be poor.…”

Section: Discussionmentioning

confidence: 99%

Modified Arthroscopic Double-Row Technique for Isolated Biceps Tenodesis

Li¹,

Tao²

2020

Preprint

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BackgroundDue to certain complications with single anchor fixation reported in the literature, we proposed a modified double-row technique for arthroscopic biceps tenodesis.MethodsFrom June 2014 to January 2018, 42 patients with isolated lesions of the long head of the biceps tendon were treated with an arthroscopic modified double-row technique. The Constant-Murley shoulder score, University of California Los Angeles shoulder score, and visual analogue scale score were evaluated preoperatively and postoperatively.ResultsAll patients were followed up for an average of 28.6 months. The mean Constant-Murley shoulder score, University of California Los Angeles shoulder score, and visual analogue scale score were significantly improved from 52.6, 12.8, and 6.4 preoperatively to 94.3, 33.1, and 0.6 at the last follow-up, respectively (P<0.001 for all). There was no postoperative incidence of persist bicipital groove pain or Popeye sign reported.ConclusionArthroscopic tenodesis with a modified double-row technique could achieve satisfactory efficacy in the treatment of lesions of the long head of the biceps tendon. This method could be an alternative and reliable option for the treatment of the long head of the biceps tendon lesion.

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Disorders of the long head of the biceps: tenotomy versus tenodesis

Cited by 4 publications

References 54 publications

A rare case of an anatomical variation of bilateral long head of the biceps brachii tendons identified within the substance of bifid subscapularis tendons

A rare case of an anatomical variation of bilateral long head of the biceps brachii tendons identified within the substance of bifid subscapularis tendons

Trends in the Treatment of Biceps Pathology: An Analysis of the American Board of Orthopaedic Surgery Database

Modified Arthroscopic Double-Row Technique for Isolated Biceps Tenodesis

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