title: Surgical indications for long head biceps tenodesis: a systematic review.
abstract: OBJECTIVE
  Tenodesis as a treatment for a symptomatic long head of biceps (LHB) tendon is becoming more prevalent and new techniques exist which are purported to make the procedure faster and more effective. The determination of appropriate surgical indications for the procedure will facilitate proper analysis and comparisons of the varied techniques. This review analyses the reported indications in the literature in an attempt to guide future research and treatment.
  
  
  METHODS
  The EMBASE and MEDLINE databases were searched to identify surgical studies that report indications for LHB tenodesis. After title, abstract searches, and full-text reviews, 39 studies were included. Study information was extracted including author, publication date, patient numbers, patient age, follow-up period, procedure performed, surgical indications, and study design.
  
  
  RESULTS
  Although indications were variable and often non-descriptive, of the 39 included studies, the most common indications for LHB tenodesis were partial tearing (51 %), instability (49 %), or tenosynovitis (44 %), SLAP tear (28 %), and positive clinical exam for LHB pain (26 %). Most studies were of low quality of evidence, such as case series (33.0 %) and retrospective studies (43.5 %), and were of low-to-moderate methodological quality.
  
  
  CONCLUSIONS
  Although indications used for LHB tenodesis are inconsistently reported, the most common indications include LHB tearing, instability, and tenosynovitis. Other indications include clinical exam indicating LHB pathology, SLAP tears and subjective shoulder pain. Rigorous reporting of indications and preoperative/operative findings should be emphasized in future studies, allowing surgeons to appropriately analyse outcomes of LHB tenodesis of different techniques within patient groups with distinct indications.
  
  
  METHODS
  Systematic review, Level IV.
authors.affiliation: Division of Orthopedic Surgery, Department of Clinical Epidemiology and Biostatistics, McMaster University, 1200 Main St West, 4E15, Hamilton, ON, L8N 3Z5, Canada.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Creech
authors.affiliation: Division of Orthopedic Surgery, Department of Clinical Epidemiology and Biostatistics, McMaster University, 1200 Main St West, 4E15, Hamilton, ON, L8N 3Z5, Canada.
authors.forename: Marco
authors.initials: M
authors.lastname: Yeung
authors.affiliation: Division of Orthopedic Surgery, Department of Clinical Epidemiology and Biostatistics, McMaster University, 1200 Main St West, 4E15, Hamilton, ON, L8N 3Z5, Canada.
authors.forename: Matthew
authors.initials: M
authors.lastname: Denkers
authors.affiliation: Division of Orthopedic Surgery, Department of Clinical Epidemiology and Biostatistics, McMaster University, 1200 Main St West, 4E15, Hamilton, ON, L8N 3Z5, Canada.
authors.forename: Nicole
authors.initials: N
authors.lastname: Simunovic
authors.affiliation: Biomechanics Laboratory, Roth McFarlane Hand and Upper Limb Center, St Joseph's Health Care, 268 Grosvenor Street, London, ON, N6A 4V2, Canada.
authors.forename: George S
authors.initials: GS
authors.lastname: Athwal
authors.affiliation: Division of Orthopedic Surgery, Department of Clinical Epidemiology and Biostatistics, McMaster University, 1200 Main St West, 4E15, Hamilton, ON, L8N 3Z5, Canada. ayenif@mcmaster.ca.
authors.forename: Olufemi R
authors.initials: OR
authors.lastname: Ayeni
mesh_terms: D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D000070599:Shoulder Injuries / Q000601:surgery*; D013708:Tendon Injuries / Q000601:surgery*; D013710:Tendons / Q000601:surgery*; D053656:Tenodesis / Q000379:methods*; D013717:Tenosynovitis / Q000601:surgery*; D016896:Treatment Outcome
keywords: Indications; Long head biceps; Outcomes; Surgical; Tenodesis