Long Head of the Biceps Tendon Complex: Pathology and Treatment Approach

Abstract

The long head of the biceps tendon (LHBT) has been and continues to be an enigmatic source of pain and dysfunction in the shoulder. Historical debates regarding its function and significance in relation to associated pathology remain unresolved and underlie the current controversies regarding treatment. While magnetic resonance imaging (MRI) has provided great advantages to diagnosis of other shoulder pathologies, the biceps tendon remains more elusive. Even arthroscopy, the gold standard of diagnosis, can be unreliable or incomplete. The myriad of surgical procedures, ranging from debridement to tenotomy to tenodesis in its many forms, suggest that there is no single superior treatment option.