Skip to main content
SpringerLink
Log in

Schmerzhafte Bizepssehne im Verlauf des Lebensalters

Painful biceps tendon in the course of aging

  • Leitthema
  • Published:
Arthroskopie Aims and scope

Zusammenfassung

Einleitung

Die lange Bizepssehne (LBS) gilt als einer der bedeutendsten Schmerzgeneratoren des Schultergelenks. Die schmerzverursachenden Pathologien, die zum Symptom der schmerzhaften Bizepssehne führen, variieren dabei in Abhängigkeit des Alters. Anhand dieser Übersichtsarbeit werden altersspezifische Ursachen für eine schmerzhafte lange Bizepssehne dargestellt.

Material und Methoden

Eine selektive Literaturrecherche wurde durchgeführt.

Ergebnisse

Neben dem Symptom der unspezifischen Tendinitis bicipitalis, die nahezu in allen Altersklassen auftreten kann, haben die meisten spezifischen Erkrankungen der langen Bizepssehne einen Altersbezug. Im Jugend- und jungen Erwachsenenalter sind SLAP-Läsionen (Läsionen des superioren Labrums von anterior nach posterior) ein häufiger Grund für eine schmerzhafte Bizepssehne. Mit zunehmendem Lebensalter rücken degenerative Veränderungen wie Pulley-Läsionen als Schmerzursache in den Vordergrund. Patienten höheren Lebensalters mit einer symptomatischen langen Bizepssehne leiden in vielen Fällen unter höhergradigen Rotatorenmanschettendefekten mit instabiler langer Bizepssehne oder unter einer Omarthrose.

Schlussfolgerung

Das Symptom der schmerzhaften langen Bizepssehne wird in Abhängigkeit des Lebensalters durch unterschiedliche pathologische Veränderungen hervorgerufen. Diese Alterszusammenhänge sollten im Rahmen von Diagnostik und Therapie von Bizepssehnenpathologien in Betracht gezogen werden.

Abstract

Background

The long biceps tendon is one of the most important pain generators of the shoulder joint. The pathologies causing the pain, which lead to the symptom of painful biceps tendon, vary depending on age. This review article presents the age-specific causes for a painful long biceps tendon.

Material and methods

A selective search of the literature was carried out.

Results

In addition to the symptom of unspecific bicipital tendonitis, which can occur in nearly all age groups, most specific diseases of the long biceps tendon are age-related. In adolescents and young adults superior labral tear from anterior to posterior (SLAP) lesions are a common reason for a painful biceps tendon. With increasing age degenerative alterations, such as pulley lesions are predominantly the cause of pain. Patients in old age with a symptomatic long biceps tendon suffer in many cases from high-grade rotator cuff defects with an unstable long biceps tendon and omarthritis.

Conclusion

The symptom of painful long biceps tendon is caused by a variety of pathological alterations depending on age. The age-dependency should be taken into consideration during the diagnostics and treatment of pathologies of the biceps tendon.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4
Abb. 5
Abb. 6
Abb. 7
Abb. 8
Abb. 9

Literatur

  1. Barile A, Lanni G, Conti L et al (2013) Lesions of the biceps pulley as cause of anterosuperior impingement of the shoulder in the athlete: potentials and limits of MR arthrography compared with arthroscopy. Radiol Med 118:112–122

    Article  CAS  PubMed  Google Scholar 

  2. Baumann B, Genning K, Bohm D et al (2008) Arthroscopic prevalence of pulley lesions in 1007 consecutive patients. J Shoulder Elbow Surg 17:14–20

    Article  PubMed  Google Scholar 

  3. Boileau P, Ahrens PM, Hatzidakis AM (2004) Entrapment of the long head of the biceps tendon: the hourglass biceps – a cause of pain and locking of the shoulder. J Shoulder Elbow Surg 13:249–257

    Article  PubMed  Google Scholar 

  4. Castagna A, Garofalo R, Cesari E (2014) No prosthetic management of massive and irreparable rotator cuff tears. Shoulder Elbow 6:147–155

    Article  PubMed  PubMed Central  Google Scholar 

  5. Castagna A, Mouhsine E, Conti M et al (2007) Chondral print on humeral head: an indirect sign of long head biceps tendon instability. Knee Surg Sports Traumatol Arthrosc 15:645–648

    Article  PubMed  Google Scholar 

  6. Connolly KP, Schwartzberg RS, Reuss B et al (2013) Sensitivity and specificity of noncontrast magnetic resonance imaging reports in the diagnosis of type-II superior labral anterior-posterior lesions in the community setting. J Bone Joint Surg Am 95:308–313

    Article  PubMed  Google Scholar 

  7. Cuff DJ, Pupello DR, Santoni BG (2016) Partial rotator cuff repair and biceps tenotomy for the treatment of patients with massive cuff tears and retained overhead elevation: midterm outcomes with a minimum 5 years of follow-up. J Shoulder Elbow Surg 25:1803–1809

    Article  PubMed  Google Scholar 

  8. Dubrow SA, Streit JJ, Shishani Y et al (2014) Diagnostic accuracy in detecting tears in the proximal biceps tendon using standard nonenhancing shoulder MRI. Open Access J Sports Med 5:81–87

    Article  PubMed  PubMed Central  Google Scholar 

  9. Elser F, Braun S, Dewing CB et al (2011) Anatomy, function, injuries, and treatment of the long head of the biceps brachii tendon. Arthroscopy 27:581–592

    Article  PubMed  Google Scholar 

  10. Godeneche A, Nove-Josserand L, Audebert S et al (2016) Relationship between subscapularis tears and injuries to the biceps pulley. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-016-4374-9

    PubMed Central  Google Scholar 

  11. Gombera MM, Kahlenberg CA, Nair R et al (2015) All-arthroscopic suprapectoral versus open subpectoral tenodesis of the long head of the biceps brachii. Am J Sports Med 43:1077–1083

    Article  PubMed  Google Scholar 

  12. Habermeyer P, Magosch P, Pritsch M et al (2004) Anterosuperior impingement of the shoulder as a result of pulley lesions: a prospective arthroscopic study. J Shoulder Elbow Surg 13:5–12

    Article  PubMed  Google Scholar 

  13. Kibler WB, Sciascia A (2016) Current Practice for the Surgical Treatment of SLAP Lesions: A Systematic Review. Arthroscopy 32:669–683

    Article  PubMed  Google Scholar 

  14. Klonz A, Loitz D, Reilmann H (2003) Proximal and distal ruptures of the biceps brachii tendon. Unfallchirurg 106:755–763

    Article  CAS  PubMed  Google Scholar 

  15. Ladermann A, Denard PJ, Collin P (2015) Massive rotator cuff tears: definition and treatment. Int Orthop 39:2403–2414

    Article  PubMed  Google Scholar 

  16. Lee BG, Cho NS, Rhee YG (2011) Results of arthroscopic decompression and tuberoplasty for irreparable massive rotator cuff tears. Arthroscopy 27:1341–1350

    Article  PubMed  Google Scholar 

  17. Maffet MW, Gartsman GM, Moseley B (1995) Superior labrum-biceps tendon complex lesions of the shoulder. Am J Sports Med 23:93–98

    Article  CAS  PubMed  Google Scholar 

  18. Morgan CD, Burkhart SS, Palmeri M et al (1998) Type II SLAP lesions: three subtypes and their relationships to superior instability and rotator cuff tears. Arthroscopy 14:553–565

    Article  CAS  PubMed  Google Scholar 

  19. Oh JH, Lee YH, Kim SH et al (2016) Comparison of Treatments for Superior Labrum-Biceps Complex Lesions With Concomitant Rotator Cuff Repair: A Prospective, Randomized, Comparative Analysis of Debridement, Biceps Tenotomy, and Biceps Tenodesis. Arthroscopy 32:958–967

    Article  PubMed  Google Scholar 

  20. Onyekwelu I, Khatib O, Zuckerman JD et al (2012) The rising incidence of arthroscopic superior labrum anterior and posterior (SLAP) repairs. J Shoulder Elbow Surg 21:728–731

    Article  PubMed  Google Scholar 

  21. Patel KV, Bravman J, Vidal A et al (2016) Tenodesis. Clin Sports Med 35(1):93–111. doi:10.1016/j.csm.2015.08.008

  22. Patterson BM, Creighton RA, Spang JT et al (2014) Surgical Trends in the Treatment of Superior Labrum Anterior and Posterior Lesions of the Shoulder: Analysis of Data From the American Board of Orthopaedic Surgery Certification Examination Database. Am J Sports Med 42:1904–1910

    Article  PubMed  Google Scholar 

  23. Refior HJ, Sowa D (1995) Long tendon of the biceps brachii: sites of predilection for degenerative lesions. J Shoulder Elbow Surg 4:436–440

    Article  CAS  PubMed  Google Scholar 

  24. Rodeo SA, Nguyen JT, Cavanaugh JT et al (2016) Clinical and Ultrasonographic Evaluations of the Shoulders of Elite Swimmers. Am J Sports Med 44:3214–3221

    Article  PubMed  Google Scholar 

  25. Sahu D, Fullick R, Giannakos A et al (2016) Sentinel sign: a sign of biceps tendon which indicates the presence of subscapularis tendon rupture. Knee Surg Sports Traumatol Arthrosc 24:3745–3749

    Article  PubMed  Google Scholar 

  26. Schaeffeler C, Waldt S, Holzapfel K et al (2012) Lesions of the biceps pulley: diagnostic accuracy of MR arthrography of the shoulder and evaluation of previously described and new diagnostic signs. Radiology 264:504–513

    Article  PubMed  Google Scholar 

  27. Sheridan K, Kreulen C, Kim S et al (2015) Accuracy of magnetic resonance imaging to diagnose superior labrum anterior-posterior tears. Knee Surg Sports Traumatol Arthrosc 23:2645–2650

    Article  PubMed  Google Scholar 

  28. Snyder SJ, Karzel RP, Del Pizzo W et al (1990) SLAP lesions of the shoulder. Arthroscopy 6:274–279

    Article  CAS  PubMed  Google Scholar 

  29. Streit JJ, Shishani Y, Rodgers M et al (2015) Tendinopathy of the long head of the biceps tendon: histopathologic analysis of the extra-articular biceps tendon and tenosynovium. Open Access J Sports Med 6:63–70

    PubMed  PubMed Central  Google Scholar 

  30. Weber SC, Martin DF, Seiler JG 3rd et al (2012) Superior labrum anterior and posterior lesions of the shoulder: incidence rates, complications, and outcomes as reported by American Board of Orthopedic Surgery. Part II candidates. Am J Sports Med 40:1538–1543

    Article  PubMed  Google Scholar 

  31. Wellmann M (2016) Diagnostics and treatment of anterosuperior rotator cuff tears. Orthopäde 45:130–135

    Article  CAS  PubMed  Google Scholar 

  32. Wilk KE, Hooks TR (2016) The Painful Long Head of the Biceps Brachii: Nonoperative Treatment Approaches. Clin Sports Med 35:75–92

    Article  PubMed  Google Scholar 

  33. Wu PT, Jou IM, Yang CC et al (2014) The severity of the long head biceps tendinopathy in patients with chronic rotator cuff tears: macroscopic versus microscopic results. J Shoulder Elbow Surg 23:1099–1106

    Article  PubMed  Google Scholar 

  34. Yildiz F, Bilsel K, Pulatkan A et al (2017) Reliability of magnetic resonance imaging versus arthroscopy for the diagnosis and classification of superior glenoid labrum anterior to posterior lesions. Arch Orthop Trauma Surg 137:241–247

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Orthopädische Praxisklinik Münster OPPK, Von-Vincke-Str. 14, 48143, Münster, Deutschland

    Malte Holschen

  2. Gelenkchirurgie Orthopädie Hannover, Uhlemeyerstr. 16, 30175, Hannover, Deutschland

    Jens D. Agneskirchner

Authors
  1. Malte Holschen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jens D. Agneskirchner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jens D. Agneskirchner.

Ethics declarations

Interessenkonflikt

M. Holschen und J.D. Agneskirchner geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Holschen, M., Agneskirchner, J.D. Schmerzhafte Bizepssehne im Verlauf des Lebensalters. Arthroskopie 30, 207–215 (2017). https://doi.org/10.1007/s00142-017-0150-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00142-017-0150-1

Schlüsselwörter

Keywords

Search

Navigation