Management of proximal biceps tendon pathology  

作　　者：Simon P Lalehzarian Avinesh Agarwalla Joseph N Liu 

机构地区：[1]The Chicago Medical School,Rosalind Franklin University of Medicine and Science,North Chicago,IL 60064,United States [2]Department of Orthopedic Surgery,Westchester Medical Center,Valhalla,NY 10595,United States [3]USC Epstein Family Center for Sports Medicine,Keck Medicine of USC,Los Angeles,CA 90033,United States

出　　处：《World Journal of Orthopedics》2022年第1期36-57,共22页世界骨科杂志（英文版）

摘　　要：The long head of the biceps tendon is widely recognized as an important pain generator,especially in anterior shoulder pain and dysfunction with athletes and working individuals.The purpose of this review is to provide a current understanding of the long head of the biceps tendon anatomy and its surrounding structures,function,and relevant clinical information such as evaluation,treatment options,and complications in hopes of helping orthopaedic surgeons counsel their patients.An understanding of the long head of the biceps tendon anatomy and its surrounding structures is helpful to determine normal function as well as pathologic injuries that stem proximally.The biceps-labral complex has been identified and broken down into different regions that can further enhance a physician’s knowledge of common anterior shoulder pain etiologies.Although various physical examination maneuvers exist meant to localize the anterior shoulder pain,the lack of specificity requires orthopaedic surgeons to rely on patient history,advanced imaging,and diagnostic injections in order to determine the patient’s next steps.Nonsurgical treatment options such as anti-inflammatory medications,physical therapy,and ultrasound-guided corticosteroid injections should be utilized before entertaining surgical treatment options.If surgery is needed,the three options include biceps tenotomy,biceps tenodesis,or superior labrum anterior to posterior repair.Specifically for biceps tenodesis,recent studies have analyzed open vs arthroscopic techniques,the ideal location of tenodesis with intra-articular,suprapectoral,subpectoral,extra-articular top of groove,and extra-articular bottom of groove approaches,and the best method of fixation using interference screws,suture anchors,or cortical buttons.Orthopaedic surgeons should be aware of the complications of each procedure and respond accordingly for each patient.Once treated,patients often have good to excellent clinical outcomes and low rates of complications.

关 键 词：Shoulder pathology Long head of the biceps tendon Biceps-labral complex Biceps tenotomy Biceps tenodesis Superior labrum anterior to posterior lesions 

分 类 号：R686.1[医药卫生—骨科学]