Anomalies of the long head of the biceps brachii tendon: clinical significance, MR arthrographic findings, and arthroscopic correlation in two patients

Gaskin, Cree M.; Golish, S. Raymond; Blount, Kevin J.; Diduch, David R.

doi:10.1007/s00256-007-0291-9

Cited by 39 publications

(33 citation statements)

References 12 publications

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“…The intertubercular sulcus has been described in cases where the LHBT is hypoplastic [Gaskin et al, 2007], although it is not present when the LHBT is absent [Ghalayini et al, 2007]. The intertubercular sulcus appeared in Carnegie stage 18 embryos in relation to the LHBT primordium.…”

Section: Discussionmentioning

confidence: 99%

“…The fetal specimens that we analyzed showed that the LHBT was free in the articular cavity or joined to the articular capsule by a mesotendon. The origin of the tendon in the articular capsule and the supraspinatus zone has been described [Egea et al, 2010;Gaskin et al, 2007;Hyman and Warren, 2001;MacDonald, 1998;Richards and Schwartz, 2003;Wahl and MacGillivray, 2007;Yeh et al, 1999].…”

Section: Discussionmentioning

confidence: 99%

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Development of the Human Biceps Brachii Tendon and Coracoglenoid Ligament (7th-12th Week of Development)

Arráez-Aybar¹,

Murillo-González²,

Herrera-Lara³

et al. 2017

Cells Tissues Organs

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The goal of this study is to clarify the development of the long head of the biceps brachii tendon (LHBT) and to verify the existence and development of the coracoglenoid ligament. Histological preparations of 22 human embryos (7-8 weeks of development) and 43 human fetuses (9-12 weeks of development) were studied bilaterally using a conventional optical microscope. The articular interzone gives rise to the LHBT, glenoid labrum, and articular capsule. During the fetal period, it was observed that in 50 cases (58%), the LHBT originated from both the glenoid labrum and the scapula, while in 36 cases (42%), it originated only from the glenoid labrum. The coracoglenoid ligament, first described by Sappey in 1867, is a constant structure that originates at the base of the coracoid process and projects toward the glenoid labrum zone, which is related to the origin of the LHBT. The coracoglenoid ligament was more easily identifiable in the 36 cases in which the LHBT originated only from the glenoid labrum. We suggest that the coracoglenoid ligament is a constant anatomical structure, is not derived from the articular interzone unlike the LHBT, and contributes to the fixation of the glenoid labrum in the scapula in cases in which the LHBT originated only from the glenoid labrum. We postulate that, when the LHBT is fixed only at the glenoid labrum, alterations in the coracoglenoid ligament could lead to a less sufficient attachment of the glenoid labrum to the scapula which could predispose to a superior labral lesion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Development of the Human Biceps Brachii Tendon and Coracoglenoid Ligament (7th-12th Week of Development)

Arráez-Aybar¹,

Murillo-González²,

Herrera-Lara³

et al. 2017

Cells Tissues Organs

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“…Without the long head of the biceps tendon there was no humeral head depressor effect to help control superior humeral head translation (Keefe and Lowe, 2005). A recent report by Gaskin et al (2007) described two cases of anomalous biceps tendons associated with anterior labral tears and instability. In both cases the long head of the biceps was present but hypoplastic.…”

Section: Discussionmentioning

confidence: 97%

Absence of the long head of the biceps tendon associated with glenoid dysplasia and posterior labral tear

et al. 2008

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Anatomic variations in the insertion of the long head of the biceps tendon and superior labral complex have been described (Erickson et al. [1992] AJR Am. J. Roentgenol. 158:1091-1096; Kreitner et al. [1998] AJR Am. J. Roentgenol. 170:599-605; Mariani et al. [1997] Arthroscopy 13:499-501; Vangsness Jr. et al. [1994] J. Bone Joint Surg. Br. 76:951-954). To the authors' knowledge, there have been only five reported cases of congenital absence of the long head of the biceps tendon. Three of these cases were associated with anterior shoulder instability, one with a superior labral anterior posterior lesion and one simply with shoulder pain. This is the first reported case of congenital absence of the biceps tendon associated with glenoid dysplasia and a posterior labral tear.

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“…These anomalies may increase the risk of acquiring shoulder instability. 2 Thus recognition of abnormalities of the biceps tendon is important because they are a common source of shoulder pain both alone or in combination with abnormalities of the rotator cuff, labrum, and other structures. Knowledge of this anomaly can be helpful in explaining unusual signs on magnetic resonance imaging.…”

Section: Discussionmentioning

confidence: 99%

“…1 The knowledge of these variants may be relevant for both glenohumeral surgery and arthroscopy. 2 The intra-articular bifurcate anomaly of the LHBT origin is relatively less frequent. This anomaly is usually undetectable on preoperative evaluations such as magnetic resonance imaging and ultrasound because of an interpretational difficulty and lack of preoperative insight toward the anomalous biceps long head.…”

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confidence: 99%

Arthroscopic Tenoplasty in Congenital Split Biceps Long Head

Yoo

Kim

Arora

2014

Arthroscopy Techniques

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The long head of the biceps brachii tendon arises mainly from the superior glenoid labrum and supraglenoid tubercle. Biceps brachii display anatomic variations, but these are rarely encountered. We report, for the first time, a technique called arthroscopic intra-articular biceps tenoplasty describing restoration of the long head of the biceps tendon using the superior capsule in a case of anomalous congenital split biceps tendon encountered incidentally during diagnostic glenohumeral arthroscopy in a patient who was treated for shoulder instability and SLAP tear.T he long head of the biceps tendon (LHBT) displays numerous anatomic variations, but their clinical relevance remains unclear.1 The knowledge of these variants may be relevant for both glenohumeral surgery and arthroscopy.2 The intra-articular bifurcate anomaly of the LHBT origin is relatively less frequent. This anomaly is usually undetectable on preoperative evaluations such as magnetic resonance imaging and ultrasound because of an interpretational difficulty and lack of preoperative insight toward the anomalous biceps long head. It usually can be found incidentally during arthroscopic procedures for other purposes. The LHBT functions as a humeral head depressor and a secondary restraint to anterior instability, particularly in the abducted and externally rotated position.3 By depressing the humeral head and elevating the glenoid labrum, the LHBT imparts dynamic stability to the glenohumeral joint. 4 Patients with this variation may have weakening of the rotator cuff. Recognition of abnormalities of the biceps tendon is important because they are a common source of shoulder pain both alone and in combination with abnormalities of the rotator cuff, labrum, and other structures.5 Preoperative awareness of the anomalous LHBT is important because it can be the etiologic basis of other structural injuries, such as rotator cuff tears and labral tears. Case Report and Operative TechniqueA 23-year-old right handedominant man presented with left shoulder pain and restriction of range of motion. He had a history of anterior shoulder dislocation from a fall onto the ground 3 months earlier, and the shoulder joint had subsequently dislocated 3 times.The clinical examination showed no tenderness along the route of the biceps tendon. Active range of motion was grossly restricted, with 90 of flexion, 80 of abduction, 20 of external rotation, and internal rotation to L5. The apprehension test, O'Brien test, crossarm sign, and Speed test were positive. There was no tenderness along the route of the LHBT.The initial radiograph showed no abnormal findings. A subsequent magnetic resonance arthrogram showed a SLAP lesion and anteroinferior labral tear. The LHBT was present in the bicipital groove. The rotator cuff was intact.Nonoperative management including oral analgesics and intra-articular or subacromial space steroids and local anesthetic injection had failed to alleviate the patient's symptoms. On the basis of the clinical findings and radiologic evidenc...

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Anomalies of the long head of the biceps brachii tendon: clinical significance, MR arthrographic findings, and arthroscopic correlation in two patients

Cited by 39 publications

References 12 publications

Development of the Human Biceps Brachii Tendon and Coracoglenoid Ligament (7th-12th Week of Development)

Development of the Human Biceps Brachii Tendon and Coracoglenoid Ligament (7th-12th Week of Development)

Absence of the long head of the biceps tendon associated with glenoid dysplasia and posterior labral tear

Arthroscopic Tenoplasty in Congenital Split Biceps Long Head

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