The proximal biceps tendon: tricks and pearls.
The diagnosis and treatment of proximal biceps tendon injuries continue to be a challenge. The difficulty lies on determining if there is isolated biceps pathology versus concomitant rotator cuff tears or instability. Imaging modalities, such as magnetic resonance imaging, continue to provide us with the extra tool to help us confirm our suspicion of additional pathology. Symptomatic biceps tendon tears can undergo debridement, tenotomy, or tenodesis if nonoperative measures fail to provide relief. Reports from performing a biceps tenotomy often give similar functional outcomes compared with tenodesis. Cosmetic deformity on the lateral arm may be noted with tenodesis and initial fatigue. Tenodesis may subject the patient to a longer rehabilitation process and increased pain. The decision of which one should be performed lies between the physician and the patient's expectations.
Busconi
Brian B
BB
Department of Orthopedics, U-Mass Medical School, Worcester, MA, USA. BusconiB@ummhc.org
DeAngelis
Nicola
N
Guerrero
Patrick E
PE
D001182:Arthroscopy / Q000009:adverse effects / Q000379:methods*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D007593:Joint Instability / Q000517:prevention & control; D008297:Male; D018482:Muscle, Skeletal / Q000503:physiopathology / Q000601:surgery; D019637:Orthopedic Procedures / Q000379:methods; D010147:Pain Measurement; D016059:Range of Motion, Articular; D018570:Risk Assessment; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012421:Rupture / Q000175:diagnosis / Q000601:surgery; D012680:Sensitivity and Specificity; D019534:Shoulder Impingement Syndrome / Q000517:prevention & control; D020069:Shoulder Pain / Q000175:diagnosis / Q000601:surgery; D013708:Tendon Injuries / Q000175:diagnosis / Q000601:surgery*; D013709:Tendon Transfer / Q000379:methods; D053656:Tenodesis / Q000379:methods*; D016896:Treatment Outcome