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Wheeless' Textbook of Orthopaedics
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Biceps Tendonitis



- See: Proximal Biceps Tendon Rupture:

- Discussion:
    - inflammation of long head of biceps tendon usually occurs w/ rotator cuff inflammation;
    - clinically, it may be difficult to differentiate the pain patterns of rotator cuff and biceps tendon inflammation;
            - symptoms indicating of biceps inflammation include pain radiating to biceps, pain w/ internal rotation, & pain w/ forward flexion of

- Shoulder Exam:
    - pain over the bicipital groove is suggestive of biceps compromise;
    - Yergason test: biceps tendon stability;
            - patient fully flexes elbow and supinates , orthopaedist externally rotates and presses downward on flexed elbow;
            - positive exam elicits pain;

- Treatment:
    - isolated biceps tenodesis is not indicated, unless shoulder reconstructive surgery is required for other reasons;
    - in the report by Daryl C. Osbahr et al, the authors question whether biceps tenodesis is necessary;
            - 5 consecutive years of patients receiving biceps tenotomy (80 patients; 40 males, 40 females; average age, 58 years) or tenodesis procedures were retrospectively
                  followed-up by grading anterior shoulder pain, muscle spasms in the biceps, and cosmetic deformity of the biceps muscle;
            - no statistical significance was found between the biceps tenotomy and biceps tenodesis groups;
            - there was also no statistical significance when comparing the biceps tenotomy and biceps tenodesis groups;







Tenodesis of the long head of the biceps brachi for chronic bicipital Tendinitis. Long-term results.

The cosmetic appearance of the biceps muscle after long-head tenotomy versus tenodesis














Original Text by Clifford R. Wheeless, III, MD.