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Tendinopathy of the Tendon of the Long Head of the Biceps

Longo, Umile Giuseppe MD, MSc*; Loppini, Mattia MD*; Marineo, Gianluca MD*; Khan, Wasim S. PhD; Maffulli, Nicola MD, MS, PhD, FRCS (Orth); Denaro, Vincenzo MD*

Sports Medicine and Arthroscopy Review: December 2011 - Volume 19 - Issue 4 - p 321–332
doi: 10.1097/JSA.0b013e3182393e23
Review Articles

Pathologies of tendon of the long head of the biceps (LHB) are an important cause of shoulder pain. They include tendinopathy, rupture, superior labrum anterior and posterior lesions, pulley tears, and tendon instability. Conservative management of symptomatic LHB tendinopathy is commonly accepted as the first-line treatment. It consists of rest, nonsteroidal anti-inflammatory drugs, corticosteroid injections, and physical therapy. Biceps tenotomy and tenodesis are the most common surgical procedures to manage both isolated LHB pathology and biceps-glenoid complex tears combined with rotator cuff tears. However, controversy persists about the superiority of one of them because there is no evidence of significant differences in functional scores or patient satisfaction between the 2 techniques. This article provides an overview on biomechanical function of the LHB and current strategies for treatment of LHB disorders.

*Department of Orthopaedic and Trauma Surgery, Campus Biomedico University, Via Alvaro del Portillo, Trigoria, Rome, Italy

University College London Institute of Orthopaedic and Musculoskeletal Sciences, Royal National Orthopaedic Hospital, Stanmore, Middlesex

Centre for Sports and Exercise Medicine, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Mile End Hospital, London, England, UK

Disclosure: The authors declare no conflict of interest.

Reprints: Umile Giuseppe Longo MD, MSc, Specialist in Trauma and Orthopaedic Surgeon, Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 Rome, Italy (e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.