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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 5/2015

01-05-2015 | Shoulder

The longitudinal anatomy of the long head of the biceps tendon and implications on tenodesis

Authors: Waqas M. Hussain, Deepak Reddy, Alfred Atanda, Morgan Jones, Mark Schickendantz, Michael A. Terry

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 5/2015

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Abstract

Purpose

Regarding biceps tenodesis, there are no evidence-based recommendations for the ideal level at which to cut and stabilize the tendon. The purpose of this study is to provide information referencing the tendon for potential clinical applications during biceps tenodesis.

Methods

Forty-three embalmed shoulder specimens were dissected, and markers were placed at four points along each biceps tendon: (1) proximal border of the bicipital groove, (2) distal border of the bicipital groove, (3) proximal edge of the pectoralis major insertion, and (4) musculotendonous junction. Using the origin as the initial point of reference, measurements were made to the four subsequent sites. The humeral length was recorded by measuring the distance between the greater tuberosity and the lateral epicondyle.

Results

Measurements were recorded from the origin of the tendon on the supraglenoid tubercle to each established point along its length, and the mean, minimum, and maximum values (cm) were calculated as follows: origin to the proximal bicipital groove [2.8 (1.9, 4.3)], distal bicipital groove [5.2 (3.8, 7.0)], pectoralis major insertion [8.1 (6.3, 10.4)], and musculotendonous junction [13.8 (7.7, 20.3)], and overall humeral length [29.2 (25.2, 32.7)]. An analysis demonstrated a statistically significant overall increase in tendon length at each anatomic site as the overall humeral length increased (p < 0.05). Utilizing the constant and coefficient data from our regression analysis, a predictive formula was calculated based on humeral length. For example, distance from the origin to each anatomic point was determined by a formula [Tendon length at each anatomic landmark, cm = coefficient (humeral length, cm) + constant] for each respective anatomic landmark along the course of the tendon.

Conclusion

This work will allow surgeons who prefer tenodesis to more accurately re-approximate the appropriate length–tension relationship of the biceps when tenodesing the tendon in a variety of locations. This benefit will potentially result in the most efficient biceps muscle–tendon function and improve the results of biceps surgery.

Level of evidence

IV.
Literature
1.
Alpantaki K, McLaughlin D, Karagogeos D, Hadjipavlou A, Kontakis G (2005) Sympathetic and sensory neural elements in the tendon of the long head of the biceps. J Bone Joint Surg Am 87(7):1580–1583CrossRefPubMed
2.
Barber A, Field LD, Ryu R (2007) Biceps tendon and superior labrum injuries: decision-marking. J Bone Joint Surg Am 89(8):1844–1855PubMed
3.
Becker DA, Cofield RH (1989) Tenodesis of the long head of the biceps brachii for chronic bicipital tendinitis. Long-term results. J Bone Joint Surg Am 71(3):376–381PubMed
4.
Berlemann U, Bayley I (1995) Tenodesis of the long head of biceps brachii in the painful shoulder: improving results in the long term. J Shoulder Elbow Surg 4(6):429–435CrossRefPubMed
5.
Bicos J (2008) Biomechanics and anatomy of the proximal biceps tendon. Sports Med Arthrosc 16(3):111–117CrossRefPubMed
6.
Cone RO, Danzig L, Resnick D, Goldman AB (1983) The bicipital groove: radiographic, anatomic, and pathologic study. Am J Roentgenol 141(4):781–788CrossRef
7.
Cooper DE, Arnoczky SP, O’Brien SJ, Warren RF, DiCarlo E, Allen AA (1992) Anatomy, histology, and vascularity of the glenoid labrum. An anatomical study. J Bone Joint Surg Am 74(1):46–52PubMed
8.
De Carli A, Vadala A, Zanzotto E, Zampar G, Vetrano M, Iorio R, Ferretti A (2012) Reparable rotator cuff tears with concomitant long-head biceps lesions: tenotomy or tenotomy/tenodesis? Knee Surg Sports Traumatol Arthrosc 20(12):2553–2558CrossRefPubMed
9.
Denard PJ, Dai X, Hanypsiak BT, Burkhart SS (2012) Anatomy of the biceps tendon: implications for restoring physiological length–tension relation during biceps tenodesis with interference screw fixation. Arthroscopy 28(10):1352–1358CrossRefPubMed
10.
Eakin CL, Faber KJ, Hawkins RJ, Hovis WD (1999) Biceps tendon disorders in athletes. J Am Acad Orthop Surg 7(5):300–310PubMed
11.
Harrell FE (2001) Regression modeling strategies: with applications to linear models, logistic regression, and survival analysis. Springer series in statistics. Springer, New YorkCrossRef
12.
Hitchcock HH, Bechtol CO (1948) Painful shoulder; observations on the role of the tendon of the long head of the biceps brachii in its causation. J Bone Joint Surg Am 30A(2):263–273PubMed
13.
Kumar VP, Satku K, Balasubramaniam P (1989) The role of the long head of biceps brachii in the stabilization of the head of the humerus. Clin Orthop Relat Res 244:172–175PubMed
14.
Lafosse L, Shah AA, Butler RB, Fowler RL (2011) Arthroscopic biceps tenodesis to supraspinatus tendon: technical note. Am J Orthop (Belle Mead NJ) 40(7):345–347
15.
Miller T, Jones G (2011) Arthroscopic evaluation and treatment of biceps brachii long head tendon injuries: a survey of the MOON shoulder group. Int J Shoulder Surg 5(3):68–71CrossRefPubMedCentralPubMed
16.
Murthi AM, Vosburgh CL, Neviaser TJ (2000) The incidence of pathologic changes of the long head of the biceps tendon. J Shoulder Elbow Surg 9(5):382–385CrossRefPubMed
17.
Post M, Benca P (1989) Primary tendinitis of the long head of the biceps. Clin Orthop Relat Res 246:117–125PubMed
18.
Sethi N, Wright R, Yamaguchi K (1999) Disorders of the long head of the biceps tendon. J Shoulder Elbow Surg 8(6):644–654CrossRefPubMed
19.
Vangsness CT, Jorgenson SS, Watson T, Johnson DL (1994) The origin of the long head of the biceps from the scapula and glenoid labrum. An anatomical study of 100 shoulders. J Bone Joint Surg Br 76(6):951–954PubMed
20.
Warner JJ, McMahon PJ (1995) The role of the long head of the biceps brachii in superior stability of the glenohumeral joint. J Bone Joint Surg Am 77(3):366–372PubMed
Metadata
Title
The longitudinal anatomy of the long head of the biceps tendon and implications on tenodesis
Authors
Waqas M. Hussain
Deepak Reddy
Alfred Atanda
Morgan Jones
Mark Schickendantz
Michael A. Terry
Publication date
01-05-2015
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 5/2015
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-014-2909-5

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