Long Head of Biceps: From Nuisance to Ally

نویسندگان

1 Rowley Bristow Unit, Ashford & St Peter’s Hospital NHS Trust, Surrey, UK, Fortius Clinic, London, UK

2 Rowley Bristow Unit, Ashford & St Peter’s Hospital NHS Trust, Surrey, UK, Fortius Clinic, London, UK

doi
10.22038/abjs.2025.91837.4159
چکیده

For decades, the long head of the biceps tendon (LHB) has been something of an enigma—viewed by some as a vestigial structure to be sacrificed, by others as a source of persistent pathology demanding intervention. The “biceps killers” have long championed tenotomy, while those of us disinclined to accept the cosmetic “Popeye” deformity—and perhaps with a little encouragement from industry—have argued for tenodesis (1).Yet to see the LHB only through the lens of “cut” or “fix” is to underestimate its true potential. In recent years, the tendon has been reimagined not merely as a structure of pathology, but as a structure of possibility. Increasingly, surgeons are recognising that the LHB can be harnessed as a dynamic and biological tool in the management of some of our most challenging shoulder conditions.Today, its applications extend beyond the binary of tenotomy versus tenodesis, into three particularly exciting domains:- Dynamic Anterior Stabilisation (DAS) for glenohumeral instability- Biological Superior Capsular Reconstruction (SCR) for irreparable rotator cuff tears- Rotator cuff repair with LHB augmentation