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J ISAKOS 2021 May 20. Epub 2021 May 20.

Department of Orthopaedics, University of Colorado at Boulder, Boulder, Colorado, USA

Importance: Arthroscopic suprapectoral biceps tenodesis (ABT) and open subpectoral biceps tenodesis (OBT) are two surgical treatment options for relief of long head of the biceps tendon (LHBT) pathology and superior labrum anterior to posterior (SLAP) tears. There is insufficient knowledge regarding the clinical superiority of one technique over the other.

Objective: To systematically review the literature in order to compare the clinical outcomes and safety of ABT and OBT for treatment of LHBT or SLAP pathology. Read More

Open Vet J 2021 01 22;10(4):457-464. Epub 2020 Dec 22.

Faculty of Veterinary Medicine, University of Calgary, 11877 85th St NW, Calgary, Alberta, T3R 1J3, Canada.

Background: Bicipital tendinitis and/or tendinopathy is a common cause of forelimb lameness in dogs, particularly in larger and more active patients. Although conservative treatment aimed at resolving discomfort and preserving the tendon remains the primary therapeutic goal, in certain cases it is necessary to surgically transect the tendon to eliminate pain and lameness. Transection of the tendon can be performed by open arthrotomy, arthroscopically, or percutaneously using a scalpel blade. Read More

Orthop J Sports Med 2021 Jan 21;9(1):2325967120977538. Epub 2021 Jan 21.

Allegheny General Hospital, Pittsburgh, Pennsylvania, USA.

Background: Lesions of the long head of the biceps can be successfully treated with biceps tenotomy or tenodesis when surgical management is elected. The advantage of a tenodesis is that it prevents the potential development of a cosmetic deformity or cramping muscle pain. Proponents of a subpectoral tenodesis believe that "groove pain" may remain a problem after suprapectoral tenodesis as a result of persistent motion of the tendon within the bicipital groove. Read More

J Pak Med Assoc 2020 Dec;70(12(A)):2270-2272

Department of Physical Therapy, University of Lahore, Pakistan.

We present a case of a 22-year-old university sportsman who presented at a private hospital in Lahore in December 2018 with complaint of severe pain in the anterolateral aspect of the right shoulder after playing cricket. On palpation, greater tubercle of the right shoulder was found to be tender along with the muscle belly of supraspinatus. A muscle trigger point was identified during palpation, while painful arc was also present on abduction. Read More

Vet Clin North Am Small Anim Pract 2021 Mar 11;51(2):323-341. Epub 2021 Jan 11.

Department of Orthopedic Surgery, Nexus Veterinary Bone & Joint Center, Baltimore, MD 21224, USA. Electronic address:

The shoulder is a complex joint composed mostly of static and dynamic capsuloligamentous structures and plays an important role in forelimb lameness. Its complex anatomy and biomechanics necessitate thorough examination and diagnostic work-up for accurate diagnosis. This article provides an updated review of common canine shoulder pathologies, including osteochondrosis, bicipital and supraspinatus tendinopathies, infraspinatus contracture, medial shoulder syndrome, and luxation. Read More

Orthop Traumatol Surg Res 2021 02 14;107(1):102747. Epub 2020 Dec 14.

Hospital Beatriz Ângelo, Loures, Portugal; Hospital da Luz, Lisboa, Portugal.

Background: The etiology and relevance of long head of biceps tendon (LHBT) pathology is debated. As it can have important therapeutic consequences and physical examination can be misleading, various morphologic parameters have been described to try to predict it.

Hypothesis: We hypothesized that bicipital groove cross-sectional area (CSA), as assessed by ultrasonography, could be related to intra-articular tendon pathology. Read More

Arthrosc Tech 2020 May 10;9(5):e611-e615. Epub 2020 Apr 10.

Department of Orthopaedics, Faculty of Medicine, Thammasat University, Pathumthani, Thailand.

Proximal tendinopathy of the long head of the biceps (LHB) is a common shoulder problem that requires surgical intervention, especially in patients with concomitant rotator cuff tears. The comparative results of biceps tenotomy and biceps tenodesis are still doubtful; both techniques show good to excellent results in terms of postoperative pain and functional outcomes. The described technique-all-arthroscopic LHB transfer-is an optional biceps tenodesis technique using all-arthroscopic soft-tissue tenodesis and arthroscopic suturing of the LHB to the short head of the biceps and coracoacromial ligament combined with release of the LHB from the bicipital groove. Read More

Orthop Traumatol Surg Res 2020 Jun 24;106(4):693-700. Epub 2020 May 24.

Department of Orthopedic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, P.O.Box 95500, 1090HM, Amsterdam. The Netherlands.

Background: Suprapectoral long head biceps (LHB) tenodesis and subpectoral LHB tenodesis are both commonly performed surgical procedures. Due to the more proximal position of the suprapectoral tenodesis site this technique may be accompanied with more postoperative pain in the bicipital groove and cramping pain in the biceps muscle. We hypothesized that subpectoral tenodesis is associated with a better clinical outcome than suprapectoral tenodesis. Read More

Arthroscopy 2020 09 20;36(9):2352-2353. Epub 2020 Apr 20.

Walter Reed National Military Medical Center, Bethesda, Maryland, U.S.A.

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

Int J Environ Res Public Health 2020 02 14;17(4). Epub 2020 Feb 14.

Division of Occupational Health, Department of Occupational Safety and Environment, Regional Government of South Hesse, 65197 Wiesbaden, Germany.

Several epidemiological studies have found an association between shoulder-loaded work activities and specific shoulder diseases. No study has derived the dose-response relationship and resulting doubling dose, important for the recognition of occupational diseases. This systematic review is an update of the van der Molen et al. Read More

J Shoulder Elbow Surg 2020 Jun 6;29(6):1289-1295. Epub 2020 Feb 6.

Division of Sports Medicine, Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA. Electronic address:

Background: Surgical options for pathology affecting the long head of the biceps tendon (LHBT) include tenotomy and tenodesis, both of which can be performed with a variety of fixation methods. This study aimed to compare surgical treatment options for LHBT lesions using a network meta-analysis of published clinical studies.

Methods: A systematic review of the literature was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Read More

Eur Radiol Exp 2020 02 7;4(1):10. Epub 2020 Feb 7.

Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany.

Background: To evaluate feasibility and diagnostic performance of clinical 7-T magnetic resonance imaging (MRI) of the shoulder.

Methods: Eight patients with suspected lesions of the rotator cuff underwent 7-T MRI before arthroscopy. Image quality was scored for artifacts, B inhomogeneities, and assessability of anatomical structures. Read More

Skeletal Radiol 2020 Apr 12;49(4):585-591. Epub 2019 Nov 12.

Department of Orthopaedics, University of Patras, Patras, Greece.

Purpose: To compare accuracy, patient discomfort, and clinical outcome of ultrasound-guided versus palpation-guided corticosteroid injections to the bicipital groove in patients with long head of biceps (LHB) tendinosis.

Materials And Methods: Forty-four patients with primary LHB tendinosis were randomized into two groups (group A, n = 22; group B, n = 22). All patients underwent treatment with a single corticosteroid injection to the bicipital groove. 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

J Shoulder Elbow Surg 2019 Dec 6;28(12):2272-2278. Epub 2019 Sep 6.

Department of Orthopaedics, Hospital Beatriz Ângelo, Loures, Portugal.

Background: Our objective was to examine the clinical utility of old and new clinical tests directed to the long head of the biceps tendon (LHBT) and to quantify the importance of proper test interpretation.

Methods: A consecutive 65 patients scheduled to undergo arthroscopic surgery were selected. Before surgery, 5 clinical tests were performed: Speed, Yergason, upper cut, biceps resisted flexion (BRF), and modified BRF (mBRF) using a dumbbell. Read More

Folia Morphol (Warsz) 2020 26;79(2):395-401. Epub 2019 Aug 26.

Department of Orthopaedic and Trauma, District Hospital, Torun, Poland.

Background: Open or mini-invasive operative procedures are methods of choice in the treatment of the advanced degenerative process of tendinopathy of long head of biceps tendon (LHBT). Cosmetic arm deformity and fatigue are the main complaints after the surgery. Researchers have noticed that in some cases the typical cosmetic deformity is often barely noticeable and the pain is significantly reduced as it occurs after spontaneous LHBT rupture due to extremely advanced tendinopathy. Read More

Diagn Interv Imaging 2019 Jul - Aug;100(7-8):437-444. Epub 2019 Mar 8.

Service d'imagerie Guilloz, hôpital central, centre hospitalier universitaire de Nancy, 29, avenue du Maréchal de Lattre de Tassigny, 54035 Nancy, France.

Purpose: The purpose of this study was to determine the performance of CT arthrography for the diagnosis of intra-articular long head of biceps (LHB) tendon intrinsic lesions using arthroscopy findings as standard of reference.

Material And Methods: CT arthrography studies of 98 patients (55 men, 43 women; mean age 54.8±12. Read More

Arthroscopy 2019 01;35(1):9-10

The San Antonio Orthopaedic Group, San Antonio, Texas.

Arthroscopy 2019 01;35(1):8-9

University Hospitals Coventry & Warwickshire, Coventry, England.

J Back Musculoskelet Rehabil 2019 ;32(2):355-359

Department of Rehabilitation Medicine, Daegu Veterans Health Service Medical Center, Daegu, Korea.

Background And Objective: Calcific tendinitis is commonly found in the rotator cuff; however, it is very rare in the long biceps tendon (LBT). Furthermore, calcific tendinitis involving the LBT in the hemiplegic shoulder after a stroke has not been previously reported.

Materials And Method: We present a case of a 63-year-old man who suffers from a stroke and atypical calcific tendinitis involving the LBT as a rare cause of hemiplegic shoulder pain. Read More

Physiother Theory Pract 2020 Mar 22;36(3):397-407. Epub 2018 Jun 22.

Physical Therapy Program, University of Colorado, Aurora, CO, USA.

: To describe the outcomes of 10 patients with chronic biceps tendinopathy treated by physical therapy with the novel approach of dry needling (DN), eccentric-concentric exercise (ECE), and stretching of the long head of the biceps tendon (LHBT). : Ten individuals reporting chronic anterior shoulder symptoms (> 3 months), pain with palpation of the LHBT, and positive results on a combination of tests including active shoulder flexion, Speed's, Hawkins Kennedy, Neer, and Yergason's tests participated in this case series. Validated self-reported outcome measures including the mean numeric pain rating scale (NPRS) and Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) were taken at baseline. Read More

Arthroscopy 2018 06;34(6):1797-1798

New York, New York.

Bicipital tunnel disease is often unvisualized during standard diagnostic arthroscopy. Histolopathologic evidence of disease may be present even in the absence of magnetic resonance imaging findings. Surgical decision making is multifactorial. Read More

Prim Care 2018 Jun;45(2):289-303

Rheumatology Fellowship, San Antonio Uniformed Services Health Education Consortium (SAUSHEC), Uniformed Services University of the Health Sciences, San Antonio Military Medical Center, 3551 Roger Brooke Drive, San Antonio, TX 78234, USA.

Soft tissue musculoskeletal pain disorders are common in the primary care setting. Early recognition and diagnosis of these syndromes minimizes patient pain and disability. This article gives a brief overview of the most common soft tissue musculoskeletal pain syndromes. Read More

J Am Anim Hosp Assoc 2018 Jul/Aug;54(4):226-230. Epub 2018 May 14.

From the Royal Veterinary College, London, United Kingdom.

A 4 mo old German shepherd dog was presented following an acute onset lameness and swelling of the thoracic limb. Clinical signs, surgical findings, and culture results were consistent with a diagnosis of necrotizing fasciitis. Initial management consisted of extensive surgical debridement, wound lavage, and bandaging. Read More

Pain Med 2019 01;20(1):138-142

Division of Anatomy, University of Toronto, Toronto, ON, Canada.

Objective: Long head biceps tendon peritendinous or sheath injections are routinely administered at or immediately distally to the bicipital groove. The main indication for injection remains the clinical diagnosis or treatment of biceps tendinopathy, although true inflammation of the tendon within the bicipital groove is rare. Because the tendon sheath is merely an extension of the joint cavity, it is plausible to assume that an injection into the sheath would result in intraarticular spread. Read More

Arch Phys Med Rehabil 2018 04 12;99(4):615-622. Epub 2018 Jan 12.

Division of Sports Medicine, Drexel University College of Medicine, Philadelphia, PA.

Objectives: To determine (1) agreement of musculoskeletal ultrasound (MSK-US) findings of shoulder pathology and related shoulder special test results in individuals with varied durations of manual wheelchair (MWC) use after spinal cord injury (SCI); and (2) whether shoulder musculoskeletal impairments, per MSK-US and clinical examination, differed in individuals with SCI and varying durations of MWC use.

Design: Cross-sectional cohort study.

Setting: Laboratory setting. Read More

Folia Morphol (Warsz) 2018 24;77(2):378-385. Epub 2017 Oct 24.

Department of Orthopaedic Surgery, Multidisciplinary Hospital Inowrocław, Poland.

Background: Tendinopathy of the long head of the biceps brachii tendon (LHBT) is one of the most common, painful conditions of the anterior part of the shoulder and often coexists with rotator cuff tears. Multifactorial aetiopathology of tendi-nopathy is poorly understood; however, several studies indicated that it is seen predominantly in areas with decreased vascularity of the tissue; the pathology is also characterised by expansive and abundant neovascular in-growth. The aim of the study was to investigate the relationship between the neovascularisation of proximal part of the LHBT and pain along the bicipital groove. Read More

Int Orthop 2018 06 25;42(6):1347-1355. Epub 2017 Aug 25.

Université François Rabelais de Tours - Faculté de Médecine de Tours - CHRU Trousseau Service d'Orthopédie Traumatologie, 1C Avenue de la République, 37170, Chambray-les-Tours, France.

Introduction: The goal of this prospective study was to assess the reliability of pre-operative cross-sectional imaging for the diagnosis of long head of biceps (LHB) tendinopathy in patients with a rotator cuff tear.

Methods: Cross-sectional imaging with MRI or CT arthrography data from 25 patients operated upon because of a rotator cuff tear between 1 October 2015 and 1 April 2016 was analysed by one experienced orthopaedic surgeon, one experienced radiologist and one orthopaedic resident. The analysis consisted of determining whether the LHB was present, the extrinsic tendon abnormalities (dislocation, tendon coverage) and intrinsic abnormalities (fraying, inflammation, degeneration). Read More