Management of symptomatic long head of biceps tendon (LHBT) pathology remains a source of debate.
The purpose of this study was to identify consensus trends for the treatment of LHBT pathology among specialists.
A survey was distributed to members of the American Shoulder and Elbow Society (ASES), consisting of three sections—demographics, case scenarios, and general LHBT pathology management. Cases presented common clinical scenarios, and surgeons reported their management preferences. Consensus responses were defined as > 50% of participants giving a single response.
One hundred and forty-two of 417 (34%) surgeons completed surveys. Forty-seven percent of questions reached a consensus answer. Biceps tenodesis was the overwhelmingly preferred technique in cases demonstrating LHBT pathology, as compared to tenotomy. No consensus, however, was reached regarding a specific surgical technique for biceps tenodesis. The two most popular techniques were arthroscopic tenodesis to bone and open subpectoral biceps tenodesis. Fellowship-trained arthroscopic surgeons and surgeons with a largely arthroscopic practice were more likely to perform tenodesis arthroscopically.
ASES members favored biceps tenodesis over tenotomy for surgical management of LHBT pathology, without consensus regarding a specific surgical technique.
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Conflict of Interest
Keith T. Corpus, MD; Grant H. Garcia, MD; Joseph N. Liu, MD; Stephen J. O’Brien, MD, MBA; Samuel A. Taylor, MD, have declared that they have no conflict of interest. David M. Dines, MD, reports personal fees from Zimmer Biomet, outside the work. Joshua S. Dines, MD, reports personal fees from Arthrex, Trice Medical, Conmed, and Linvatec; other from American Journal of Orthopedics and Journal of Shoulder and Elbow Surgery; outside the work.
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).
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Level of Evidence: Level V: Therapeutic Study.
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Corpus, K.T., Garcia, G.H., Liu, J.N. et al. Long Head of Biceps Tendon Management: a Survey of the American Shoulder and Elbow Surgeons. HSS Jrnl 14, 34–40 (2018). https://doi.org/10.1007/s11420-017-9575-3
- long head biceps tendon
- biceps tenodesis
- biceps tenotomy
- expert opinion