Skip to main content

Proximal Biceps Tendon Pathologies

  • Chapter
  • First Online:
Sports Injuries

Abstract

Proximal biceps tendon pathologies are the important cause of shoulder pain and dysfunction. However, they are still not completely understood, and both clinic and radiologic diagnosis are unclear. Arthroscopic examination of the shoulder has altered our understanding of and approach to treatment for conditions of the long head of biceps tendon. Biceps tenotomy and tenodesis are the surgical treatment options. Factors that need to be taken into account when choosing between tenotomy and tenodesis are the activity expectations of the patient, the importance of the cosmetic result, and patient compliance. The functional role of the long head of biceps tendon at the shoulder is limited. For that reason, surgeons should be aware that retaining a pathological tendon has a more negative functional consequence than the loss of the tendon itself.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 219.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Ahrens, P.M., Boileau, P.: The long head of biceps and associated tendinopathy. J. Bone Joint Surg. Br. 89(8), 1001–1009 (2007)

    Article  PubMed  CAS  Google Scholar 

  2. Barber, F.A., Field, L.D., Ryu, R.K.: Biceps tendon and superior labrum injuries: decision making. Instr. Course Lect. 57, 527–538 (2008)

    PubMed  Google Scholar 

  3. Burkhead, W.Z., Arcand, M.A., Zeman, C., et al.: The biceps tendon. In: Rockwood, C.A., Matsen, F.A., Wirth, M.A., et al. (eds.) The Shoulder, vol. 2, 3rd edn, pp. 1059–1119. WB Saunders, Philadelphia (2004)

    Google Scholar 

  4. Boileau, P., Ahrens, P.M., Hatzidakis, A.M.: Entrapment of the long head of the biceps tendon: the hourglass biceps a cause of pain and locking of the shoulder. J. Shoulder Elbow Surg. 13, 249–257 (2004)

    Article  PubMed  Google Scholar 

  5. Carpenter, J.E., Wening, J.D., Mell, A.G., et al.: Changes in the long head of the biceps tendon in rotator cuff tear shoulders. Clin. Biomech. 20, 162–165 (2005)

    Article  Google Scholar 

  6. Chen, C.H., Hsu, K.Y., Chen, W.J., et al.: Incidence and severity of biceps long head tendon lesion in patients with complete rotator cuff tears. J. Trauma 58, 1189–1193 (2005)

    Article  PubMed  Google Scholar 

  7. Curtis, A.S., Snyder, S.J.: Evaluation and treatment of biceps tendon pathology. Orthop. Clin. North Am. 24(1), 33–43 (1993)

    PubMed  CAS  Google Scholar 

  8. Elkousy, H.A., Fluhme, D.J., O’Connor, D.P., Rodosky, M.W.: Arthroscopic biceps tenodesis using the percutaneous, intra-articular trans-tendon technique: preliminary results. Orthopaedics 28, 1316–1319 (2005)

    Google Scholar 

  9. Favorito, P.J., Harding, W.G., Heidt, R.S.: Complete arthroscopic examination of the long head of the biceps tendon. Arthroscopy 17, 430–432 (2001)

    Article  PubMed  CAS  Google Scholar 

  10. Friedman, D.J., Dunn, J.C., Higgins, L.D., Warner, J.J.: Proximal biceps tendon: injuries and management. Sports Med. Arthrosc. 16(3), 162–169 (2008)

    Article  PubMed  Google Scholar 

  11. Froimson, A.I., Oh, I.: Keyhole tenodesis of biceps origin at the shoulder. Clin. Orthop. 112, 245–249 (1975)

    Article  PubMed  Google Scholar 

  12. Gerber, C., Sebesta, A.: Impingement of the deep surface of the subscapularis tendon and reflection pulley on the antero-superior glenoid rim: a preliminary report. J. Shoulder Elbow Surg. 9, 483–490 (2000)

    Article  PubMed  CAS  Google Scholar 

  13. Glueck, D.A., Mair, S.D., Johnson, D.L.: Shoulder instability with absence of the long head of the biceps tendon. Arthroscopy 19, 787–789 (2003)

    Article  PubMed  Google Scholar 

  14. Habermeyer, P., Magosch, P., Pritsch, M., et al.: Anterosuperior impingement of the shoulder as a result of pullet lesions: a prospective arthroscopic study. J. Shoulder Elbow Surg. 13, 5–12 (2004)

    Article  PubMed  Google Scholar 

  15. Hsu, S.H., Miller, S.L., Curtis, A.S.: Long head of biceps tendon pathology: management alternatives. Clin. Sports Med. 27(4), 747–762 (2008)

    Article  PubMed  Google Scholar 

  16. Kuhn, J.E., Lindholm, S.R., Huston, L.J., et al.: Failure of the biceps superior labral complex: a cadaveric biomechanical investigation comparing the late cocking and early deceleration positions of throwing. Arthroscopy 19, 373–379 (2003)

    Article  PubMed  Google Scholar 

  17. Lafosse, L., Reiland, Y., Baier, G.P., et al.: Anterior and posterior instability of the long head of the biceps tendon in rotator cuff tears: a new classification based on arthroscopic observations. Arthroscopy 23, 73–80 (2007)

    Article  PubMed  Google Scholar 

  18. McFarland, E.G., Kim, T.K., Savino, R.M.: Clinical assessment of three common tests for superior labral antero-posterior lesions. Am. J. Sports Med. 30, 810–815 (2002)

    PubMed  Google Scholar 

  19. Mohtadi, N.G., Vellet, A.D., Clark, M.L., et al.: A prospective, double-blind comparison of magnetic resonance imaging and arthroscopy in the evaluation of patients presenting with shoulder pain. J. Shoulder Elbow Surg. 13, 258–265 (2004)

    Article  PubMed  Google Scholar 

  20. Neer II, C.S.: Anterior acromioplasty for the chronic impingement syndrome in the shoulder. J. Bone Joint Surg. Am. 87, 1399 (2005)

    Article  PubMed  Google Scholar 

  21. Nam, E.K., Snyder, S.J.: The diagnosis and treatment of superior labrum, anterior and posterior (SLAP) lesions. Am. J. Sports Med. 31(5), 798–810 (2003)

    PubMed  Google Scholar 

  22. Osbahr, D.C., Diamond, A.B., Speer, K.P.: The cosmetic appearance of the biceps muscle after long-head tenotomy versus tenodesis. Arthroscopy 18, 483–487 (2002)

    Article  PubMed  Google Scholar 

  23. Patton, W.C., McCluskey III, G.M.: Biceps tendinitis and subluxation. Clin. Sports Med. 20(3), 505–529 (2001)

    Article  PubMed  CAS  Google Scholar 

  24. Ryu, J.H., Pedowitz, R.A.: Rehabilitation of biceps tendon disorders in athletes. Clin. Sports Med. 29(2), 229–246 (2010)

    Article  PubMed  Google Scholar 

  25. Sethi, N., Wright, R., Yamaguchi, K.: Disorders of the long head of the biceps tendon. J. Shoulder Elbow Surg. 8(6), 644–654 (1999)

    Article  PubMed  CAS  Google Scholar 

  26. Tennent, T.D., Beach, W.R., Meyers, J.F.: A review of the special tests associated with shoulder examination: part II: laxity, instability, and superior labral anterior and posterior (SLAP) lesions. Am. J. Sports Med. 31, 301–307 (2003)

    PubMed  Google Scholar 

  27. Tuoheti, Y., Itoi, E., Minagawa, H., et al.: Attachment types of the long head of the biceps tendon to the glenoid labrum and their relationships with the glenohumeral ligaments. Arthroscopy 21, 1242–1249 (2005)

    Article  PubMed  Google Scholar 

  28. Toshiaki, A., Itoi, E., Minagawa, H., et al.: Cross-sectional area of the tendon and the muscle of the biceps brachii in shoulders with rotator cuff tears: a study of 14 cadaveric shoulders. Acta Orthop. 76, 509–512 (2005)

    Article  PubMed  Google Scholar 

  29. Vangsness Jr., C.T., Jorgenson, S.S., Watson, T., Johnson, D.L.: The origin of the long head of the biceps from the scapula and glenoid labrum: an anatomical study of 100 shoulders. J. Bone Joint Surg. Br. 76-B, 951–954 (1994)

    Google Scholar 

  30. Verma, N.N., Drakos, M., O’Brien, S.J.: Arthroscopic transfer of the long head biceps to the conjoint tendon. Arthroscopy 21, 764 (2005)

    PubMed  Google Scholar 

  31. Walsh, G., Edwards, B.E., Boulahia, A., et al.: Arthroscopic tenotomy of the long head of the biceps in the treatment of rotator cuff tears: clinical and radiographic results of 307 cases. J. Shoulder Elbow Surg. 14, 238–246 (2005)

    Article  Google Scholar 

  32. Walsh, G., Nove-Josserand, L., Levigne, C., et al.: Tears of the supraspinatus tendon associated with “hidden” lesions of the rotator interval. J. Shoulder Elbow Surg. 3, 353–360 (1994)

    Article  Google Scholar 

  33. Warner, J.J.P., McMahon, P.J.: The role of the long head of the biceps brachii in superior stability of the glenohumeral joint. J. Bone Joint Surg. Am. 77, 336–372 (1995)

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mehmet Demirtaş .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Demirtaş, M., Kocaoğlu, B., Karahan, M. (2012). Proximal Biceps Tendon Pathologies. In: Doral, M. (eds) Sports Injuries. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-15630-4_25

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-15630-4_25

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-15629-8

  • Online ISBN: 978-3-642-15630-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics