Long Head of Biceps Tendon Management: a Survey of the American Shoulder and Elbow Surgeons

Abstract

Background:: Management of symptomatic long head of biceps tendon (LHBT) pathology remains a source of debate. Questions/Purposes:: The purpose of this study was to identify consensus trends for the treatment of LHBT pathology among specialists. Methods:: A survey was distributed to members of the American Shoulder and Elbow Society (ASES), consisting of three sections—demographics, case scenarios, and general LHBT pathology management. Cases presented common clinical scenarios, and surgeons reported their management preferences. Consensus responses were defined as > 50% of participants giving a single response. Results:: One hundred and forty-two of 417 (34%) surgeons completed surveys. Forty-seven percent of questions reached a consensus answer. Biceps tenodesis was the overwhelmingly preferred technique in cases demonstrating LHBT pathology, as compared to tenotomy. No consensus, however, was reached regarding a specific surgical technique for biceps tenodesis. The two most popular techniques were arthroscopic tenodesis to bone and open subpectoral biceps tenodesis. Fellowship-trained arthroscopic surgeons and surgeons with a largely arthroscopic practice were more likely to perform tenodesis arthroscopically. Conclusion:: ASES members favored biceps tenodesis over tenotomy for surgical management of LHBT pathology, without consensus regarding a specific surgical technique.