Long Head of the Biceps Tendinopathy: Diagnosis and Management

Shane J. Nho, MD, MS, Eric J. Strauss, MD, Brett A. Lenart, MD, CDR Matthew T. Provencher, MD, MC, USN, Augustus D. Mazzocca, MD, MS, Nikhil N. Verma, MD and Anthony A. Romeo, MD J Am Acad Orthop Surg, Vol 18, No 11, November 2010

Abstract: 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.