Tendinopathy of the long head of the biceps brachii encompasses a spectrum of pathology ranging from inflammatory tendinitis to degenerative tendinosis. Disorders of the long head of the biceps often occur in conjunction with other shoulder pathology. A thorough patient history, physical examination, and radiographic evaluation are necessary for diagnosis. Nonsurgical management, including rest, nonsteroidal anti-inflammatory drugs, physical therapy, and injections, is attempted first in patients with mild disease. Surgical management is indicated for refractory or severe disease. In addition to simple biceps tenotomy, a variety of tenodesis techniques has been described. Open biceps tenodesis has been used historically. However, promising results have recently been reported with arthroscopic tenodesis.
From the Department of Orthopaedic Surgery, Section of Shoulder and Elbow Surgery, Division of Sports Medicine, Rush University Medical Center, Chicago, IL (Dr. Nho, Dr. Strauss, Dr. Lenart, Dr. Verma, and Dr. Romeo), Department of Orthopaedic Surgery, Naval Medical Center San Diego, San Diego, CA (Dr. Provencher), and New England Musculoskeletal Institute, University of Connecticut Health Center, Farmington, CT (Dr. Mazzocca).
The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, Department of Defense, or US Government.
J Am Acad Orthop Surg 2010;18: 645-656
Copyright 2010 by the American Academy of Orthopaedic Surgeons.