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Rev Bras Ortop (Sao Paulo) 2020 Jun 27;55(3):329-338. Epub 2020 Feb 27.

Departamento de Ortopedia e Traumatologia, Centro de Traumatologia do Esporte (CETE), Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil.

 To identify the clinical, radiological, and arthroscopic correlation of long head of the biceps tendon injuries and their influence on pain when associated with rotator cuff injuries.  Between April and December 2013, 50 patients were evaluated, including 38 (76%) women and 12 (24%) men, with a mean age of 65.1 years old. Read More

J Ultrason 2020 15;20(81):e129-e134. Epub 2020 Jun 15.

LEONARDO, Hirslanden Clinic Birshof , Münchenstein, Baselland , Switzerland.

Degenerative or traumatic ruptures of the distal biceps tendon are less common than proximal lesions. Distal lesions lead to a significant loss of function with usually considerable discomfort for patients. Therefore, precise diagnostics using operator-dependent high-resolution musculoskeletal ultrasound with illustration of the extent of the affected tendon lesion are important for optimizing patient management. Read More

Am J Sports Med 2020 Jun 24:363546520921177. Epub 2020 Jun 24.

Department of Orthopaedic Surgery, Wexner Medical Center, The Ohio State University, Columbus, Ohio, USA.

Background: Superior labrum anterior-posterior (SLAP) lesion is a common shoulder injury, particularly in overhead athletes. While surgical management has traditionally consisted of SLAP repair, high rates of revision and complications have led to alternative techniques, such as biceps tenodesis (BT). While BT is commonly reserved for older nonoverhead athletes, indications for its use have expanded in recent years. Read More

Arthrosc Tech 2020 Jun 23;9(6):e829-e835. Epub 2020 May 23.

St Georges University Medical Center, Lebanon, Beirut.

This article aims to describe a modification of the arthroscopic suture bridge technique for repair of a massive (>3 cm) rotator cuff tear. The method uses 2 medial anchors and 2 lateral anchors for rotator cuff repair, as well as double-row biceps tenodesis. This operative modification may impart better tendon healing and fewer rupture complications than the traditional double-row repair techniques. Read More

J Hand Ther 2020 Jun 18. Epub 2020 Jun 18.

Spectrum Institute for Health and Rehabilitation, Newmarket, ON, Canada.

Study Design: Repeated case study.

Introduction: Complete rupture of the distal biceps tendon occurs mostly within the middle-aged male population. Surgical repair is traditionally recommended. Read More

Skeletal Radiol 2020 Jun 15. Epub 2020 Jun 15.

Department of Radiology and Imaging Sciences Section of Musculoskeletal Imaging, Emory University Hospital, 59 Executive Park South, 4th Floor Suite 4009, Atlanta, GA, 30329, USA.

The biceps brachii myotendinous unit is a common source of shoulder, arm, and elbow pain. Its complex anatomy can present a challenge when interpreting MR images. We discuss the clinical and imaging presentations of injury related to the proximal biceps brachii separately in another manuscript. Read More

Acta Biomed 2020 May 30;91(4-S):183-188. Epub 2020 May 30.

Department of Orthopedics and Traumatology, Policlinic of Modena, University of Modena and Reggio Emilia..

Background: Several techniques of surgical repair of biceps tendon ruptures are described in literature. Cortical button repair have shown minimal loss of elbow flexion, supination and strength. In this retrospective study we report the outcomes in terms of elbow function and complications of tension-slide technique and interference screw. Read More

Foot Ankle Spec 2020 Jun 12:1938640020929577. Epub 2020 Jun 12.

Translational Medicine, Parc Tauli University Hospital, Sabadell, Spain.

The rupture of the Achilles tendon (AT) usually occurs in high-caliber athletes, but low-demand patients are also are risk, mainly if they are under corticoids or quinolones. The diagnosis of the AT rupture is usually neglected, and this could result in a worse prognosis for the patient if not treated in an appropriate time. For these patients or for those with high surgical risk, an option of minimally invasive surgery remains attractive. Read More

Balkan Med J 2020 Jun 10. Epub 2020 Jun 10.

Department of Cardiology, KardiyoRitm Cardiac Health Centre, İzmir, Turkey.

Acta Neurochir (Wien) 2020 Jun 6. Epub 2020 Jun 6.

Sarah Network of Rehabilitation Hospitals, Brasilia, Brazil.

Background: To recover biceps strength in patients with complete brachial plexus injuries, the intercostal nerve can be transferred to the musculocutaneous nerve. The surgical results are very controversial, and most of the studies with good outcomes and large samples were carried out in Asiatic countries. The objective of the study was to evaluate biceps strength after intercostal nerve transfer in patients undergoing this procedure in a Western country hospital. Read More

JSES Int 2020 Jun 3;4(2):231-237. Epub 2020 Mar 3.

Department of Orthopaedic Surgery, University of Missouri, Columbia, MO, USA.

Background: Primary repair of a severely retracted distal biceps tendon can pose a technical challenge. We sought to describe the method and clinical outcomes of a surgical technique used as an adjunct to the conventional anterior single-incision repair for severely retracted biceps tendons. This technique involves a second anterior incision proximally to retrieve a severely retracted tendon followed by passing the tendon through a soft-tissue tunnel. Read More

Arthrosc Tech 2020 May 25;9(5):e683-e689. Epub 2020 Apr 25.

Houston Methodist Orthopedic and Sports Medicine, Houston, Texas, U.S.A.

Distal biceps tendon ruptures are thought to be secondary to an acute forceful eccentric load on a degenerative tendon. Nonoperative treatment following rupture leads to significantly decreased forearm supination and elbow flexion strength. There are several techniques described in the literature for repair. Read More

Skeletal Radiol 2020 May 29. Epub 2020 May 29.

Stoke Mandeville Hospital, Buckingahmshire Healthcare NHS Trust, Aylesbury, UK.

Objective: To delineate the spectrum of traumatic knee injuries associated with injury of the anterolateral ligament of the knee (ALL).

Materials And Methods: A retrospective review of 200 MRI scans undertaken for acute knee trauma was performed. In each scan, the ALL was scored as normal, sprained or torn. Read More

Clin Sports Med 2020 Jul 16;39(3):661-672. Epub 2020 Apr 16.

University of Pittsburgh Medical Center, Pittsburgh Steelers, Burke and Bradley Orthopaedics, 200 Delafield Road, Suite 4010, Pittsburgh, PA 15215, USA. Electronic address:

Distal biceps tendon injuries typically occur from forced eccentric contraction against a heavy load and are more common in males than females. Most patients who rupture their distal biceps tendon undergo operative repair to minimize strength loss and fatigue. Single-incision and two-incision techniques have been developed in recent decades and achieve satisfactory outcomes. Read More

Kaohsiung J Med Sci 2020 May 15. Epub 2020 May 15.

Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey.

J Shoulder Elbow Surg 2020 May 4. Epub 2020 May 4.

Ventura Orthopedics, Clinical Faculty at Community Memorial Health System Orthopedic Residency, Ventura, CA, USA.

Background: Distal biceps tendon avulsions account for 3%-10% of all biceps ruptures. Treated nonoperatively, these injuries lead to a loss of endurance, supination strength, and flexion strength compared with operative repair or reconstruction. Operative management of chronic injury has classically been with graft tissue to augment the contracted muscle. Read More

Acta Orthop Belg 2019 Dec;85(4):459-463

This study presents a series of cases with surgically treated partial distal biceps tendon ruptures. The results of full distal biceps tendon rupture repair are also presented and a comparison is made between the two groups. Between 2001 and 2015, patients with partial and full ruptures of the distal biceps tendon were surgically repaired. Read More

J Shoulder Elbow Surg 2020 Apr 29. Epub 2020 Apr 29.

Department of Orthopaedic Surgery, AZ Monica, Deurne, Belgium; Department of Orthopaedic Surgery, University Hospital Antwerp, Edegem, Belgium.

Background: Various techniques have been described for distal biceps tendon reinsertion. Although high success rates have been reported, all current techniques have specific shortcomings, with complications such as heterotopic ossification, nerve damage, and gap formation. The purpose of the present study was to biomechanically evaluate a new intramedullary fixation device that might reduce the risk of posterior interosseous nerve lesions. Read More

Rev Bras Ortop (Sao Paulo) 2020 Apr 27;55(2):191-197. Epub 2020 Apr 27.

Departamento de Ortopedia, Universidade Estadual de Campinas, Campinas, SP, Brasil.

 To evaluate 15 patients with ruptured distal biceps tendon submitted to reinsertion via a single, anterior and transverse approach using two anchors. They were submitted to a rehabilitation protocol and, within six months, to an evaluation of the range of motion and strength intensity during flexion and supination of the operated elbow.  The data were collected prospectively, and were analyzed through the Mann-Whitney test and the mixed-model test to evaluate the force between the operated and non-operated elbows. Read More

BMC Musculoskelet Disord 2020 Apr 27;21(1):270. Epub 2020 Apr 27.

Department of Trauma and Orthopaedic Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Frankfurt am Main, Germany.

Background: Surgical reattachment of the tendon is still the gold standard for ruptures of the distal biceps brachii tendon. Several fixation techniques have been described in the literature, with suture anchors being one of the most common fixation techniques. Currently, there is no data available on how many anchors are required for a safe and stable refixation. Read More

Arthroscopy 2020 Apr 20. Epub 2020 Apr 20.

Address: TSAOG Orthopaedics and the Burkhart Research Institute for Orthopaedics (BRIO), 400 Concord Plaza Dr., San Antonio, TX 78258.

Subpectoral biceps tenodesis of the shoulder may be a useful tool that can address a wide range of disorders in the setting of pathology of the long head of the biceps tendon. Primary indications include: (1) zone 2 or zone 3 tendon pathology and (2) failed previous proximal tendon tenodesis. Secondary indications include: (1) an overhead athlete or thrower, (2) chronic tendinopathy and (3) surgeon preference. Read More

J Shoulder Elbow Surg 2020 Jun 16;29(6):e229-e237. Epub 2020 Apr 16.

Department of Orthopedics, University of Utah, Salt Lake City, UT, USA.

Background: Given the similar outcomes of various fixation constructs for single-incision distal biceps repair, a critical evaluation of the factors that drive the cost of the procedure is the key to optimizing treatment value. The purpose of this study was to quantify variation in costs for surgical treatment of complete distal biceps ruptures, as well as identify factors affecting costs.

Methods: We retrospectively identified adult patients consecutively treated surgically for complete distal biceps ruptures between July 2011 and January 2018 at a single academic medical center. Read More

J Shoulder Elbow Surg 2020 Apr;29(4):853-858

Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.

Background: Distal biceps reconstruction for chronic rupture often requires a graft to recover length and allow for distal tendon reattachment to bone. Our purpose was to assess peak strength and endurance recovery following biceps reconstruction with tendon grafts.

Hypothesis: We hypothesized that allograft reconstruction would result in decreased flexion and supination peak strength and endurance. Read More

World J Orthop 2020 Feb 18;11(2):123-128. Epub 2020 Feb 18.

Department of Orthopaedic Surgery, Singapore General Hospital, Singapore 169856, Singapore.

We report an unusual case of the long head of the biceps brachii tendon rupture near the musculotendinous junction in a young patient. The injury occurred in a young athlete during sports competition. The clinical presentation, surgical treatment, and technique with tenodesis using a unicortical button of the ruptured tendon were presented. Read More

J Shoulder Elbow Surg 2020 May 5;29(5):1002-1009. Epub 2020 Mar 5.

Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada. Electronic address:

Background: Among an active aging population, distal biceps tendon ruptures are becoming increasingly common. Typically, they are the result of an acute heavy eccentric load being placed on an already contracted muscle, and surgery is the gold standard treatment for optimal clinical and functional outcomes. Although improved strength has been shown after operative repair, there is little evidence available regarding a timeframe for return to work-related activity. Read More

J Am Acad Orthop Surg Glob Res Rev 2019 Dec 11;3(12). Epub 2019 Dec 11.

Department of Orthopaedics at Thomas Jefferson University, Philadelphia, PA (Mr. Salmons, Dr. Warrender, and Ms. Smith), and Philadelphia Hand to Shoulder Center, King of Prussia, PA (Dr. Kearns and Dr. Strohl).

Traumatic intrasubstance ruptures of the biceps brachii are rare. Injury to its tendinous insertion or origin is most common. Isolated short head injuries are rare, and musculocutaneous nerve involvement has been reported for these injuries. Read More

JBJS Essent Surg Tech 2019 Oct-Dec;9(4). Epub 2019 Nov 26.

University of Alabama at Birmingham, Birmingham, Alabama.

Background: A subscapularis-sparing approach to anatomic total shoulder arthroplasty (TSA) is used for patients with glenohumeral osteoarthritis who have an intact rotator cuff and sufficient bone volume.

Description: A 7 to 10-cm anterosuperior incision is made with the patient in the beach chair position. The anterolateral deltoid muscle raphe is split, and the shoulder is externally rotated to bring the rotator interval to the field. Read More

J Orthop 2020 Jul-Aug;20:111-118. Epub 2019 Dec 14.

School of Medicine, University of Central Lancashire, United Kingdom.

Aims: To assess whether the degree of radiological retraction and chronicity of distal biceps tendon ruptures are related to the ability to reattach the tendon and long-term functional outcomes.

Methods: Analysis of consecutive patients undergoing surgery for distal biceps tendon ruptures by a single surgeon. Measurements regarding the site and degree of tendon retraction in relation to anatomical landmarks following rupture were correlated with intraoperative findings. Read More

BMJ Case Rep 2020 Feb 9;13(2). Epub 2020 Feb 9.

Department of Orthopedic Surgery, EHC, Morges, Switzerland.

Non-displaced proximal humerus fractures are usually managed non-operatively despite of minor malalignment. Biceps tendon rupture due to attrition after malunion is rare around the proximal humerus. Rupture of the long head of biceps (LHB) tendon usually occurs inside the joint close to the origin at the labrum. Read More

Instr Course Lect 2019 ;68:499-512

Knowledge regarding the importance of the superior labrum in shoulder function is evolving as biomechanical and clinical studies define the roles of the labrum in shoulder function and dysfunction. The diagnosis of the clinically significant labral injury, the alteration in labral anatomy that is associated with the production of clinical symptoms and dysfunction and requires management, is based on specific history and clinical examination findings that point to the loss of labral roles. Surgical management should address all aspects of the altered labral anatomy and repair the labral structure to allow normal labral roles without excessive biceps tension. Read More

BMJ Case Rep 2020 Feb 4;13(2). Epub 2020 Feb 4.

Kuala Kedah Health Clinic, Alor Setar, Malaysia.

Shoulder Elbow 2020 Feb 15;12(1):54-62. Epub 2019 Jan 15.

Department of Trauma and Orthopaedics, Flinders University, Adelaide, Australia.

Background: The biceps brachii is the main forearm supinator, which is a direct consequence of its anatomic arrangement. The primary aim of distal biceps rupture is to restore supination strength and function. Cadaveric studies demonstrate that anatomic repairs significantly improve the supination moment when compared to more anterior repairs; however, this has not been tested in the clinical setting. Read More

Skeletal Radiol 2020 Jul 31;49(7):1081-1088. Epub 2020 Jan 31.

Department of Radiology and Diagnostic Imaging, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.

Objective: Distal biceps brachii tendon (DBBT) rupture is an uncommon but functionally significant injury given the loss of supination, flexion strength and pain that often result. Prompt surgical repair is preferred in most patients. Clinicoradiological post-operative follow-up is typically performed to assess DBBT repair integrity and function, frequently using ultrasound, though to date, no studies have described post-operative DBBT repair sonographic appearances. Read More

Orthopedics 2020 May 5;43(3):e182-e186. Epub 2020 Feb 5.

Subscapularis tendon tears in the pediatric population are most commonly associated with an avulsion fracture of the lesser tuberosity. Isolated subscapularis tendon ruptures are infrequently reported. According to previous reports, the diagnosis of subscapularis tendon injuries in pediatric patients is often delayed and management is typically conservative. Read More

Rev Esp Cir Ortop Traumatol 2020 Mar - Apr;64(2):77-82. Epub 2020 Jan 27.

Unidad de Miembro Superior, Hospital MAZ, Zaragoza, España.

Objective: The main purpose of this study is to determine the agreement between two radiological tests, ultrasonography and magnetic resonance, in the diagnosis of distal brachial biceps tendon injury.

Material And Method: A retrospective study was made of patients over 3 years who underwent distal brachial biceps tendon reattachment open surgery, and whose preoperative diagnosis was complemented either by ultrasonography, by magnetic resonance or both. The agreement was calculated by Cohen's kappa coefficient (k). Read More

Einstein (Sao Paulo) 2020 27;18:eRC4778. Epub 2020 Jan 27.

Universidade Federal de São Paulo, São Paulo, SP, Brazil.

This is a case report of a previously healthy athlete who did not use oral anticoagulant, suffered a rupture of the distal biceps brachii tendon, and evolved with arm compartment syndrome. An emergency fasciotomy and the repair of the tendon were performed. After surgery the patient had a good recovery of the paresthesia and sensibility. Read More

BMJ Case Rep 2020 Jan 12;13(1). Epub 2020 Jan 12.

Division of Orthopaedic Surgery, Etobicoke General Hospital, Etobicoke, Ontario, Canada.

A 34-year-old man, with previous anabolic steroid abuse, presented with right shoulder pain following an underhand bowling swing. Examination indicated a Popeye sign of the right biceps, and positive Speeds, Yergason and O'Brian's tests. MRI indicated a complete tear of the intra-articular portion of the long head of biceps tendon (LHBT). Read More

QJM 2020 May;113(5):377-378

Department of Neurology, Klinikum Wels-Grieskirchen, Grieskirchnerstrasse 42, Wels 4600, Austria.

QJM 2020 May;113(5):379-380

Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan Wangfujing, Beijing 100730, China.

JSES Open Access 2019 Dec 30;3(4):361-364. Epub 2019 Sep 30.

Rothman Orthopaedic Institute, The Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.

Arthrosc Tech 2019 Dec 21;8(12):e1511-e1515. Epub 2019 Nov 21.

Department of Orthopedic Surgery, Nanoori Suwon Hospital, Suwon, Republic of Korea.

Although the long head of the biceps tendon is known to resist superior movement of the humeral head in the shoulder joint and assist flexion and supination of the elbow joint, its exact function remains unclear. Moreover, the ideal treatment of lesions of the long head of the biceps tendon such as tendinitis, subluxation, dislocation, and partial or complete rupture remains controversial. Various tenodesis methods have been introduced by many authors. Read More

Joints 2018 Dec 11;6(4):228-231. Epub 2019 Oct 11.

Ortopedia, Ospedale san Camillo de Lellis, Rieti, Italy.

Traumatic lesions of the distal biceps brachii are uncommon. They often result from rapid elbow flexion against resistance. Conservative treatment is only indicated in low-demanding patient and in those who have severe comorbidities. Read More

Arthroscopy 2019 12;35(12):3316-3317

Bern, Switzerland.

Given the high prevalence of rotator cuff tears and their socioeconomic impact, surgeons and researchers have tried to understand their etiology and pathomechanism for almost hundred years. Articles about tendon degeneration with increasing age dominate the literature, and numerous factors contributing to tendon degeneration have been identified. One of them, the lateral extension of the acromion, as quantitated using the acromion index or the critical shoulder angle, has become very popular in the last few years. Read More

Knee Surg Sports Traumatol Arthrosc 2020 02 27;28(2):658-659. Epub 2019 Nov 27.

Ramsay Santé, Hôpital Privé de l'Estuaire, Le Havre, France.

Orthop Traumatol Surg Res 2019 12 13;105(8):1549-1553. Epub 2019 Nov 13.

Department of Orthopedic Surgery, Etimesgut Şehit Sait Ertürk State Hospital, Ankara, Turkey.

Introduction: Although numerous risk factors have been described, the effects of temperament, which is defined as a risk factor for certain disorders, on the outcome of patients undergoing rotator cuff surgery have not been investigated.

Hypothesis: We investigated whether a relationship exists between affective temperament and the outcome of patients undergoing rotator cuff surgery.

Material And Methods: The outcomes of 176 patients undergoing rotator cuff surgery were examined using the Oxford and Constant questionnaires as well as visual analog scale values preoperatively and postoperatively. Read More

J Orthop Surg Res 2019 Nov 15;14(1):370. Epub 2019 Nov 15.

Department of Arthroscopy and Sports Medicine, The Second Hospital of Inner Mongolia Medical University, No. 1 Yingfang Street, Huimin District, Hohhot, 010000, Inner Mongolia Autonomous Region, China.

Background: The best treatment for lesions of the long head of the biceps tendon (LHBT) with concomitant reparable rotator cuff tears is still controversial. The purpose of the meta-analysis was to compare clinical outcomes of biceps tenotomy and tenodesis for LHBT lesions.

Methods: A literature retrieval was conducted in MEDLINE, Embase, and Cochrane Library from 1979 to March 2018. Read More

Am J Sports Med 2019 12 13;47(14):3483-3490. Epub 2019 Nov 13.

Shoulder and Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.

Background: All-suture anchors are increasingly being used in rotator cuff repair. However, there are debates on the micromotion of all-suture anchors.

Purpose: To perform rotator cuff repair on patients with rotator cuff tears and different shoulder bone mineral densities (BMDs) and investigate (1) where the anchor is located under the cortex, (2) if there is any anchor migration settling during follow-up, and (3) if structural outcome differs according to shoulder BMD. Read More

JSES Open Access 2019 Oct 11;3(3):225-231. Epub 2019 Sep 11.

Department of Mechanical Engineering and Materials Science, University of Pittsburgh, Pittsburgh, PA, USA.

Background: The distal biceps tendon externally rotates from proximal to distal before inserting onto the radius. Our hypothesis is that an externally rotated (anatomic) repair would re-create native supination moment arm and flexion force, whereas an internally rotated (nonanatomic) repair would result in reduced force transmission.

Methods: The mechanical tests performed in this study measured isometric moment arms and elbow flexion force using a validated elbow simulator as previously published. Read More

JSES Open Access 2019 Oct 13;3(3):145-153. Epub 2019 Sep 13.

Department of Orthopaedic Surgery, The Cleveland Clinic Foundation, Cleveland, OH, USA.

Background: Glenoid morphology can influence the outcomes of total shoulder arthroplasty. This study examines the results of a new technique according to preoperative glenoid staging. We hypothesized that there would be no statistically significant difference in outcomes between Levine concentric (Walch A) and Levine nonconcentric (Walch B) glenoids treated for primary glenohumeral arthritis using nonspherical humeral head and inlay glenoid replacement. Read More

BMC Musculoskelet Disord 2019 Nov 9;20(1):522. Epub 2019 Nov 9.

Clinic of Trauma Surgery, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany.

Background: Simple tenotomy and anchor tenodesis are commonly used in treatment of long biceps tendon (LHB) pathologies. The tenotomy can result in biceps distalization or cosmetic deformities. A novel loop Tenodesis Technique (LTD) could prevent a distalization of the biceps muscle without the risk of implant associated complications. Read More