The influence of bicipital groove morphology on the stability of the long head of the biceps tendon

Abstract

Purpose: We aimed to evaluate the influence of the bony morphology of the bicipital groove on the stability of the long head of the biceps tendon (LHBT). Methods: Among the patients who underwent magnetic resonance imaging of the shoulder at our outpatient clinic in 2012, those aged >40 years were included. After excluding cases with complete tear or unclear positioning of the biceps tendon, 464 shoulders were analyzed according to the position of the LHBT with respect to the bicipital groove. Shoulders with subluxation or dislocation of the LHBT were labeled as having unstable LHBT, while those with the LHBT located in the bicipital groove were labeled as having stable LHBT. The bony morphology of the bicipital groove was measured in terms of opening angle, medial wall angle, and depth. A shallow bicipital groove was defined as having an opening angle >94 , concurrent with earlier studies. We compared shoulders with stable and unstable LHBT regarding bicipital bony morphology. We also compared shoulders with normal and shallow grooves regarding tendon stability. Results: Shoulders with stable and unstable LHBT differed significantly regarding bony morphology. Shoulders with unstable LHBT showed a shallower mean depth (by 0.3 mm; p ¼ 0.008), a smaller mean medial angle (by 2.2 ; p ¼ 0.014), and a larger mean opening angle (by 3.7 ; p ¼ 0.016). Bony morphology characterized by a shallow groove was significantly associated with increased prevalence of instability defined as LHBT subluxation or dislocation (p ¼ 0.011). Conclusion: A shallow bicipital groove, identified by the larger opening angle, smaller medial angle, and shallower depth, may represent a predisposing factor for biceps tendon instability.

Congenital absence of the bilateral long heads of the biceps brachii tendons in a patient with Silver-Russell syndrome

“…The most common variation is the presence of a supernumerary head, which has an estimated prevalence of 15.4% in one study of 175 cadavers [8] . Supernumerary heads of the LHBT are also associated with variations of the musculocutaneous and median nerves, which may be associated with nerve compression and neurological symptoms [ 3 , 9 ]. Despite the prevalence of LHBT variations, its absence, and particularly bilateral absence, has not been commonly reported in the literature.…”

Anchoring Apparatus of Long Head of the Biceps Tendon: Ultrasonographic Anatomy and Pathologic Conditions

“…The bicipital groove is visualized in the transverse plane as a concave and highly echogenic line on the US (Figure 2). Theoretically, the osseous dimensions of the bicipital groove contributes to the stability of the LHBT; several studies based on MRI suggest the presence of a spur on the bicipital groove [11], a larger opening angle, a smaller medial angle and a shallower depth are predisposing factors for biceps tendon instability [12]. With ultrasound, however, these dimensions or the cross-sectional area are not related to the stability or other pathologies of the LHBT [13,14].…”

Evaluation of the Relationship between Biceps-Glenoid Angle and Subscapularis Tendon Pathologies in the Biceps Long Head Tendon Subluxation with MRI

“…Biseps uzun başı tendonunun (BUBT) bisipital oluk ile ilişkisinin bir miktar korunarak ortadan kalkması subluksasyon olarak adlandırılır (1)(2)(3). BUBT stabilitesi bisipital olukta bulunan transvers humeral ligaman, süperior glenohumeral ligaman ve korakohumeral ligamandan oluşan biseps pulley mekanizması ve subskapularis tendon yapıları ile sağlanır (2)(3)(4)(5)(6)(7). BUBT subluksasyonu için, biseps pulley mekanizmasını oluşturan anatomik yapılardan birinin defektif olması gerekir (1,3,4,7).…”

“…BUBT stabilitesi bisipital olukta bulunan transvers humeral ligaman, süperior glenohumeral ligaman ve korakohumeral ligamandan oluşan biseps pulley mekanizması ve subskapularis tendon yapıları ile sağlanır (2)(3)(4)(5)(6)(7). BUBT subluksasyonu için, biseps pulley mekanizmasını oluşturan anatomik yapılardan birinin defektif olması gerekir (1,3,4,7). BUBT'nun bisipital oluk ile ilişkisinin tamamen ortadan kalkması dislokasyon, kontağın bir miktar korunması subluksasyon olarak adlandırılır (1,3,7…”

“…BUBT subluksasyonu için, biseps pulley mekanizmasını oluşturan anatomik yapılardan birinin defektif olması gerekir (1,3,4,7). BUBT'nun bisipital oluk ile ilişkisinin tamamen ortadan kalkması dislokasyon, kontağın bir miktar korunması subluksasyon olarak adlandırılır (1,3,7…”