While tenotomy and tenodesis both have been advocated to create good clinical outcome, a discussion remained over the favored treatment option in lesions of the biceps pulley system (BPS) and the long head of the biceps tendon (LHB). LHB tenodesis can avoid the three major complaints after tenotomy: (1) distalization of the biceps muscle belly resulting in a so-called “popeye” deformity, (2) cramping and soreness of the biceps muscle belly, and (3) fatigue discomfort and loss of flexion/supination strength in the elbow. These disorders play an important role in the young and active patient. Therefore, tenodesis should be preferred in younger patients who are involved in sports activities and in manually laboring employees. No general recommendation about the technique for tenodesis could be given that is mostly up to the preference of the surgeon.
Biceps pulley system Long head of the biceps Pulley lesion Biceps tendon instability Biceps tenodesis
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