Advances in diagnosis and treatment of rotator cuff injury associated with long head of biceps tendon lesion_West China Medical Journal

Authors：

LI Yupeng ¹ ,  YANG Xiao ^1,2

1. School of Medicine UESTC, Chengdu, Sichuan 610054, P. R. China;
2. Department of Orthopedics, Sichuan Academy of Medicine Sciences, Sichuan Provincial People’s Hospital, Chengdu, Sichuan 610072, P. R. China;

Corresponding author：

YANG Xiao, Email: yangxiaomed@163.com

Keywords：

Rotator cuff injury; long head of biceps tendon; anatomy; diagnosis; treatment

DOI：

10.7507/1002-0179.202207077

Video：

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Rotator cuff injuries are often associated with long head of biceps tendon (LHBT) lesions, which are more common in middle-aged and older adults. With the continuous updating of diagnosis and treatment techniques and treatment concepts in recent years, many patients can receive effective diagnosis and treatment. This article starts from the anatomy, etiology, diagnosis and treatment progress of rotator cuff and LHBT, and details the related research progress of rotator cuff injury combined with LHBT at home and abroad. This paper focuses on the significance of paying attention to LHBT lesions while dealing with rotator cuff injuries, aiming to improve clinicians’ understanding of rotator cuff injuries combined with LHBT lesions, explore accurate and effective diagnosis and treatment systems, so as to choose the best treatment method.

Citation： LI Yupeng, YANG Xiao. Advances in diagnosis and treatment of rotator cuff injury associated with long head of biceps tendon lesion. West China Medical Journal, 2022, 37(10): 1576-1581. doi: 10.7507/1002-0179.202207077 Copy

1.	Gomoll AH, Katz JN, Warner JJ, et al. Rotator cuff disorders: recognition and management among patients with shoulder pain. Arthritis Rheum, 2004, 50(12): 3751-3761.
2.	鲁谊, 杨珖, 李岳, 等. 肩袖损伤合并肱二头肌长头腱病变的危险因素及其对肩关节功能的影响. 中华骨科杂志, 2021, 41(8): 471-479.
3.	Lafosse L, Reiland Y, Baier GP, et al. Anterior and posterior instability of the long head of the biceps tendon in rotator cuff tears: a new classification based on arthroscopic observations. Arthroscopy, 2007, 23(1): 73-80.
4.	Bigliani LU, Cordasco FA, McLlveen SJ, et al. Operative repair of massive rotator cuff tears: long-term results. J Shoulder Elbow Surg, 1992, 1(3): 120-130.
5.	Zhao J, Xue H, Yao J, et al. The “hand as foot” teaching method in the anatomy of musculotendinous cuff. Asian J Surg, 2022, 45(5): 1152-1153.
6.	李智尧, 马立峰, 郭艾. 肩袖损伤病理及生物力学研究进展. 临床和实验医学杂志, 2021, 20(18): 2014-2016.
7.	Curtis AS, Burbank KM, Tierney JJ, et al. The insertional footprint of the rotator cuff: an anatomic study. Arthroscopy, 2006, 22(6): 609.e1.
8.	Vosloo M, Keough N, De Beer MA. The clinical anatomy of the insertion of the rotator cuff tendons. Eur J Orthop Surg Traumatol, 2017, 27(3): 359-366.
9.	Taylor SA, O’Brien SJ. Clinically relevant anatomy and biomechanics of the proximal biceps. Clin Sports Med, 2016, 35(1): 1-18.
10.	Sarmento M. Long head of biceps: from anatomy to treatment. Acta Reumatol Port, 2015, 40(1): 26-33.
11.	Woertler K. Rotator interval. Semin Musculoskelet Radiol, 2015, 19(3): 243-253.
12.	Ladd LM, Crews M, Maertz NA. Glenohumeral joint instability: a review of anatomy, clinical presentation, and imaging. Clin Sports Med, 2021, 40(4): 585-599.
13.	Itoigawa Y, Itoi E. Anatomy of the capsulolabral complex and rotator interval related to glenohumeral instability. Knee Surg Sports Traumatol Arthrosc, 2016, 24(2): 343-349.
14.	Zappia M, Reginelli A, Russo A, et al. Long head of the biceps tendon and rotator interval. Musculoskelet Surg, 2013, 97(Suppl 2): S99-S108.
15.	Chen CH, Hsu KY, Chen WJ, et al. Incidence and severity of biceps long head tendon lesion in patients with complete rotator cuff tears. J Trauma, 2005, 58(6): 1189-1193.
16.	Murthi AM, Vosburgh CL, Neviaser TJ. The incidence of pathologic changes of the long head of the biceps tendon. J Shoulder Elbow Surg, 2000, 9(5): 382-385.
17.	Ahmad ZY, Diaz LE, Roemer FW, et al. Imaging review of subscapularis tendon and rotator interval pathology. Radiol Res Pract, 2022, 2022: 4009829.
18.	Akhtar A, Richards J, Monga P. The biomechanics of the rotator cuff in health and disease - a narrative review. J Clin Orthop Trauma, 2021, 18: 150-156.
19.	Plachel F, Moroder P, Gehwolf R, et al. Risk factors for rotator cuff disease: an experimental study on intact human subscapularis tendons. J Orthop Res, 2020, 38(1): 182-191.
20.	Bartoszewski N, Parnes N. Rotator cuff injuries. JAAPA, 2018, 31(4): 49-50.
21.	Branca Vergano L, Corsini G, Monesi M. Long head of biceps in proximal fractures of the humerus: an underestimated problem?. Acta Biomed, 2020, 91(4-S): 69-78.
22.	Zhu XM, Leroux T, Ben-David E, et al. A meta-analysis of level I evidence comparing tenotomy vs tenodesis in the management of long head of biceps pathology. J Shoulder Elbow Surg, 2021, 30(5): 961-968.
23.	Jain NB, Luz J, Higgins LD, et al. The diagnostic accuracy of special tests for rotator cuff tear: the ROW cohort study. Am J Phys Med Rehabil, 2017, 96(3): 176-183.
24.	Hippensteel KJ, Brophy R, Smith MV, et al. Comprehensive review of provocative and instability physical examination tests of the shoulder. J Am Acad Orthop Surg, 2019, 27(11): 395-404.
25.	Cardoso A, Amaro P, Barbosa L, et al. Diagnostic accuracy of clinical tests directed to the long head of biceps tendon in a surgical population: a combination of old and new tests. J Shoulder Elbow Surg, 2019, 28(12): 2272-2278.
26.	Hegedus EJ, Goode AP, Cook CE, et al. Which physical examination tests provide clinicians with the most value when examining the shoulder? Update of a systematic review with meta-analysis of individual tests. Br J Sports Med, 2012, 46(14): 964-978.
27.	张联庆, 刘振兴. 冈上肌出口位 X 线片肩峰-肱骨头间距在肩袖损伤诊断中的意义. 医疗装备, 2019, 32(6): 43-44.
28.	Mellano CR, Shin JJ, Yanke AB, et al. Disorders of the long head of the biceps tendon. Instr Course Lect, 2015, 64: 567-576.
29.	Seltzer SE, Finberg HJ, Weissman BN, et al. Arthrosonography: gray-scale ultrasound evaluation of the shoulder. Radiology, 1979, 132(2): 467-468.
30.	Ostrowski JL, Beaumont A, Dochterman E. Diagnostic accuracy of musculoskeletal ultrasound on long head biceps tendon pathologies. J Sport Rehabil, 2021, 30(7): 1098-1101.
31.	Zoga AC, Kamel SI, Hynes JP, et al. The evolving roles of MRI and ultrasound in first-line imaging of rotator cuff injuries. AJR Am J Roentgenol, 2021, 217(6): 1390-1400.
32.	Liang W, Wu H, Dong F, et al. Diagnostic performance of ultrasound for rotator cuff tears: a systematic review and meta-analysis. Med Ultrason, 2020, 22(2): 197-202.
33.	Zabrzyński J, Paczesny Ł, Zabrzyńska A, et al. Sonography in the instability of the long head of the biceps tendon confronted with histopathologic and arthroscopic findings. Folia Morphol (Warsz), 2018, 77(3): 583-590.
34.	Simon MJK, Regan WD. Utilization of MRI in surgical decision making in the shoulder. BMC Musculoskelet Disord, 2022, 23(1): 588.
35.	Gimarc DC, Lee KS. Shoulder MR imaging versus ultrasound: how to choose. Magn Reson Imaging Clin N Am, 2020, 28(2): 317-330.
36.	McCrum E. MR imaging of the rotator cuff. Magn Reson Imaging Clin N Am, 2020, 28(2): 165-179.
37.	Li L, Dong J, Li Q, Dong J, et al. MRA improves sensitivity than MRI for the articular-sided partial-thickness rotator cuff tears. Sci Prog, 2021, 104(4): 368504211059976.
38.	Rol M, Favard L, Berhouet J. Diagnosis of long head of biceps tendinopathy in rotator cuff tear patients: correlation of imaging and arthroscopy data. Int Orthop, 2018, 42(6): 1347-1355.
39.	Onks C, Silvis M, Loeffert J, et al. Conservative care or surgery for rotator cuff tears?. J Fam Pract, 2020, 69(2): 66-72.
40.	Aboelmagd T, Rees J, Gwilym S. Rotator cuff tears: pathology and non-surgical management. Orthop Trauma, 2018, 32(3): 159-164.
41.	Panico L, Roy T, Namdari S. Long head of the biceps tendon ruptures: biomechanics, clinical ramifications, and management. JBJS Rev, 2021, 9(10): e21.00092.
42.	Ryösä A, Laimi K, Äärimaa V, et al. Surgery or conservative treatment for rotator cuff tear: a meta-analysis. Disabil Rehabil, 2017, 39(14): 1357-1363.
43.	黄加强, 夏红, 蒋锐中, 等. 肱二头肌肌腱长头在肩袖损伤中的应用. 临床与病理杂志, 2020, 40(12): 3303-3307.
44.	Dang A, Davies M. Rotator cuff disease: treatment options and considerations. Sports Med Arthrosc Rev, 2018, 26(3): 129-133.
45.	Di Benedetto P, Mancuso F, Tosolini L, et al. Treatment options for massive rotator cuff tears: a narrative review. Acta Biomed, 2021, 92(S3): e2021026.
46.	Creech MJ, Yeung M, Denkers M, et al. Surgical indications for long head biceps tenodesis: a systematic review. Knee Surg Sports Traumatol Arthrosc, 2016, 24(7): 2156-2166.
47.	钟名金, 柳海峰, 彭亮权, 等. 肱二头肌长头腱病变的诊疗进展. 中国运动医学杂志, 2019, 38(5): 429-433.
48.	Fang JH, Dai XS, Yu XN, et al. Lesions of the long head of the biceps tendon concomitant with rotator cuff tears: tenotomy or subpectoral mini-open tenodesis? A comparative short to mid-term follow-up study. Orthop Surg, 2019, 11(5): 857-863.
49.	Goubier JN, Bihel T, Dubois E, et al. Loop biceps tenotomy: an arthroscopic technique for long head of biceps tenotomy. Arthrosc Tech, 2014, 3(4): e427-e430.
50.	Patel KV, Bravman J, Vidal A, et al. Biceps tenotomy versus tenodesis. Clin Sports Med, 2016, 35(1): 93-111.
51.	Ahmed AF, Toubasi A, Mahmoud S, et al. Long head of biceps tenotomy versus tenodesis: a systematic review and meta-analysis of randomized controlled trials. Shoulder Elbow, 2021, 13(6): 583-591.
52.	尚西亮, 吕婧仪, 陈疾忤, 等. 关节镜下肱二头肌长头腱转位固定辅助替代上关节囊重建(Chinese Way)修补巨大及不可修复肩袖撕裂的临床疗效. 中国运动医学杂志, 2019, 38(8): 652-657.

1. Gomoll AH, Katz JN, Warner JJ, et al. Rotator cuff disorders: recognition and management among patients with shoulder pain. Arthritis Rheum, 2004, 50(12): 3751-3761.
2. 鲁谊, 杨珖, 李岳, 等. 肩袖损伤合并肱二头肌长头腱病变的危险因素及其对肩关节功能的影响. 中华骨科杂志, 2021, 41(8): 471-479.
3. Lafosse L, Reiland Y, Baier GP, et al. Anterior and posterior instability of the long head of the biceps tendon in rotator cuff tears: a new classification based on arthroscopic observations. Arthroscopy, 2007, 23(1): 73-80.
4. Bigliani LU, Cordasco FA, McLlveen SJ, et al. Operative repair of massive rotator cuff tears: long-term results. J Shoulder Elbow Surg, 1992, 1(3): 120-130.
5. Zhao J, Xue H, Yao J, et al. The “hand as foot” teaching method in the anatomy of musculotendinous cuff. Asian J Surg, 2022, 45(5): 1152-1153.
6. 李智尧, 马立峰, 郭艾. 肩袖损伤病理及生物力学研究进展. 临床和实验医学杂志, 2021, 20(18): 2014-2016.
7. Curtis AS, Burbank KM, Tierney JJ, et al. The insertional footprint of the rotator cuff: an anatomic study. Arthroscopy, 2006, 22(6): 609.e1.
8. Vosloo M, Keough N, De Beer MA. The clinical anatomy of the insertion of the rotator cuff tendons. Eur J Orthop Surg Traumatol, 2017, 27(3): 359-366.
9. Taylor SA, O’Brien SJ. Clinically relevant anatomy and biomechanics of the proximal biceps. Clin Sports Med, 2016, 35(1): 1-18.
10. Sarmento M. Long head of biceps: from anatomy to treatment. Acta Reumatol Port, 2015, 40(1): 26-33.
11. Woertler K. Rotator interval. Semin Musculoskelet Radiol, 2015, 19(3): 243-253.
12. Ladd LM, Crews M, Maertz NA. Glenohumeral joint instability: a review of anatomy, clinical presentation, and imaging. Clin Sports Med, 2021, 40(4): 585-599.
13. Itoigawa Y, Itoi E. Anatomy of the capsulolabral complex and rotator interval related to glenohumeral instability. Knee Surg Sports Traumatol Arthrosc, 2016, 24(2): 343-349.
14. Zappia M, Reginelli A, Russo A, et al. Long head of the biceps tendon and rotator interval. Musculoskelet Surg, 2013, 97(Suppl 2): S99-S108.
15. Chen CH, Hsu KY, Chen WJ, et al. Incidence and severity of biceps long head tendon lesion in patients with complete rotator cuff tears. J Trauma, 2005, 58(6): 1189-1193.
16. Murthi AM, Vosburgh CL, Neviaser TJ. The incidence of pathologic changes of the long head of the biceps tendon. J Shoulder Elbow Surg, 2000, 9(5): 382-385.
17. Ahmad ZY, Diaz LE, Roemer FW, et al. Imaging review of subscapularis tendon and rotator interval pathology. Radiol Res Pract, 2022, 2022: 4009829.
18. Akhtar A, Richards J, Monga P. The biomechanics of the rotator cuff in health and disease - a narrative review. J Clin Orthop Trauma, 2021, 18: 150-156.
19. Plachel F, Moroder P, Gehwolf R, et al. Risk factors for rotator cuff disease: an experimental study on intact human subscapularis tendons. J Orthop Res, 2020, 38(1): 182-191.
20. Bartoszewski N, Parnes N. Rotator cuff injuries. JAAPA, 2018, 31(4): 49-50.
21. Branca Vergano L, Corsini G, Monesi M. Long head of biceps in proximal fractures of the humerus: an underestimated problem?. Acta Biomed, 2020, 91(4-S): 69-78.
22. Zhu XM, Leroux T, Ben-David E, et al. A meta-analysis of level I evidence comparing tenotomy vs tenodesis in the management of long head of biceps pathology. J Shoulder Elbow Surg, 2021, 30(5): 961-968.
23. Jain NB, Luz J, Higgins LD, et al. The diagnostic accuracy of special tests for rotator cuff tear: the ROW cohort study. Am J Phys Med Rehabil, 2017, 96(3): 176-183.
24. Hippensteel KJ, Brophy R, Smith MV, et al. Comprehensive review of provocative and instability physical examination tests of the shoulder. J Am Acad Orthop Surg, 2019, 27(11): 395-404.
25. Cardoso A, Amaro P, Barbosa L, et al. Diagnostic accuracy of clinical tests directed to the long head of biceps tendon in a surgical population: a combination of old and new tests. J Shoulder Elbow Surg, 2019, 28(12): 2272-2278.
26. Hegedus EJ, Goode AP, Cook CE, et al. Which physical examination tests provide clinicians with the most value when examining the shoulder? Update of a systematic review with meta-analysis of individual tests. Br J Sports Med, 2012, 46(14): 964-978.
27. 张联庆, 刘振兴. 冈上肌出口位 X 线片肩峰-肱骨头间距在肩袖损伤诊断中的意义. 医疗装备, 2019, 32(6): 43-44.
28. Mellano CR, Shin JJ, Yanke AB, et al. Disorders of the long head of the biceps tendon. Instr Course Lect, 2015, 64: 567-576.
29. Seltzer SE, Finberg HJ, Weissman BN, et al. Arthrosonography: gray-scale ultrasound evaluation of the shoulder. Radiology, 1979, 132(2): 467-468.
30. Ostrowski JL, Beaumont A, Dochterman E. Diagnostic accuracy of musculoskeletal ultrasound on long head biceps tendon pathologies. J Sport Rehabil, 2021, 30(7): 1098-1101.
31. Zoga AC, Kamel SI, Hynes JP, et al. The evolving roles of MRI and ultrasound in first-line imaging of rotator cuff injuries. AJR Am J Roentgenol, 2021, 217(6): 1390-1400.
32. Liang W, Wu H, Dong F, et al. Diagnostic performance of ultrasound for rotator cuff tears: a systematic review and meta-analysis. Med Ultrason, 2020, 22(2): 197-202.
33. Zabrzyński J, Paczesny Ł, Zabrzyńska A, et al. Sonography in the instability of the long head of the biceps tendon confronted with histopathologic and arthroscopic findings. Folia Morphol (Warsz), 2018, 77(3): 583-590.
34. Simon MJK, Regan WD. Utilization of MRI in surgical decision making in the shoulder. BMC Musculoskelet Disord, 2022, 23(1): 588.
35. Gimarc DC, Lee KS. Shoulder MR imaging versus ultrasound: how to choose. Magn Reson Imaging Clin N Am, 2020, 28(2): 317-330.
36. McCrum E. MR imaging of the rotator cuff. Magn Reson Imaging Clin N Am, 2020, 28(2): 165-179.
37. Li L, Dong J, Li Q, Dong J, et al. MRA improves sensitivity than MRI for the articular-sided partial-thickness rotator cuff tears. Sci Prog, 2021, 104(4): 368504211059976.
38. Rol M, Favard L, Berhouet J. Diagnosis of long head of biceps tendinopathy in rotator cuff tear patients: correlation of imaging and arthroscopy data. Int Orthop, 2018, 42(6): 1347-1355.
39. Onks C, Silvis M, Loeffert J, et al. Conservative care or surgery for rotator cuff tears?. J Fam Pract, 2020, 69(2): 66-72.
40. Aboelmagd T, Rees J, Gwilym S. Rotator cuff tears: pathology and non-surgical management. Orthop Trauma, 2018, 32(3): 159-164.
41. Panico L, Roy T, Namdari S. Long head of the biceps tendon ruptures: biomechanics, clinical ramifications, and management. JBJS Rev, 2021, 9(10): e21.00092.
42. Ryösä A, Laimi K, Äärimaa V, et al. Surgery or conservative treatment for rotator cuff tear: a meta-analysis. Disabil Rehabil, 2017, 39(14): 1357-1363.
43. 黄加强, 夏红, 蒋锐中, 等. 肱二头肌肌腱长头在肩袖损伤中的应用. 临床与病理杂志, 2020, 40(12): 3303-3307.
44. Dang A, Davies M. Rotator cuff disease: treatment options and considerations. Sports Med Arthrosc Rev, 2018, 26(3): 129-133.
45. Di Benedetto P, Mancuso F, Tosolini L, et al. Treatment options for massive rotator cuff tears: a narrative review. Acta Biomed, 2021, 92(S3): e2021026.
46. Creech MJ, Yeung M, Denkers M, et al. Surgical indications for long head biceps tenodesis: a systematic review. Knee Surg Sports Traumatol Arthrosc, 2016, 24(7): 2156-2166.
47. 钟名金, 柳海峰, 彭亮权, 等. 肱二头肌长头腱病变的诊疗进展. 中国运动医学杂志, 2019, 38(5): 429-433.
48. Fang JH, Dai XS, Yu XN, et al. Lesions of the long head of the biceps tendon concomitant with rotator cuff tears: tenotomy or subpectoral mini-open tenodesis? A comparative short to mid-term follow-up study. Orthop Surg, 2019, 11(5): 857-863.
49. Goubier JN, Bihel T, Dubois E, et al. Loop biceps tenotomy: an arthroscopic technique for long head of biceps tenotomy. Arthrosc Tech, 2014, 3(4): e427-e430.
50. Patel KV, Bravman J, Vidal A, et al. Biceps tenotomy versus tenodesis. Clin Sports Med, 2016, 35(1): 93-111.
51. Ahmed AF, Toubasi A, Mahmoud S, et al. Long head of biceps tenotomy versus tenodesis: a systematic review and meta-analysis of randomized controlled trials. Shoulder Elbow, 2021, 13(6): 583-591.
52. 尚西亮, 吕婧仪, 陈疾忤, 等. 关节镜下肱二头肌长头腱转位固定辅助替代上关节囊重建(Chinese Way)修补巨大及不可修复肩袖撕裂的临床疗效. 中国运动医学杂志, 2019, 38(8): 652-657.

West China Medical Journal

Advances in diagnosis and treatment of rotator cuff injury associated with long head of biceps tendon lesion

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