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Review
. 2019 Jun;12(2):72-79.
doi: 10.1007/s12178-019-09539-5.

Injuries of the Biceps and Superior Labral Complex in Overhead Athletes

Kyle W Morse  1 , Jonathan-James Eno  2 , David W Altchek  2 , Joshua S Dines  2
Affiliations
Review

Injuries of the Biceps and Superior Labral Complex in Overhead Athletes

Kyle W Morse et al. Curr Rev Musculoskelet Med. 2019 Jun.

Abstract

Purpose of review: To summarize the current anatomy, biomechanics, presentation, treatment, and outcomes of injuries to the biceps and superior labral complex in overhead athletes.

Recent findings: The biceps and superior labral complex is composed of anatomically distinct zones. The inability to accurately diagnose biceps lesions contributes to continued morbidity especially as arthroscopy and advanced imaging fail to fully evaluate the entire course of the biceps tendon. Superior labrum anterior and posterior (SLAP) repair, long head of biceps tenodesis, and tenotomy are the most common operative techniques for surgical treatment of biceps-labral complex (BLC) pathology. Labral repair in overhead athletes has resulted in mixed outcomes for athletes and is best indicated for patients under age 40 years old. Injuries to the BLC are potentially challenging injuries to diagnose and treat, particularly in the overhead athlete. SLAP repair remains the treatment of choice for high-level overhead athletes and patients younger than 40 years of age, while biceps tenodesis and tenotomy are preferred for older patients.

Keywords: Long head of biceps tendon; Overhead athletes; SLAP; Superior labral complex; Tenodesis; Tenotomy.

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Conflict of interest statement

Kyle W. Morse, Jonathan-James Eno, and David W. Altchek each declare no potential conflicts of interest.

Joshua S. Dines reports personal fees from Linvatec (royalties), Trice (paid consultant), and Arthrex, Inc. (paid consultant, paid presenter or speaker, research support, Linvatec: IP royalties). Dr. Dines reports royalties and financial support from Wolters Kluwer-Health-Lippincott Williams & Wilkins. Dr. Dines serves as a section editor for Current Reviews in Musculoskeletal Medicine.

Figures

Fig. 1
Fig. 1
Coronal view of a MRI showing a superior labrum consistent with a superior labrum anterior and posterior (SLAP) tear
Fig. 2
Fig. 2
Intraoperative arthroscopic photograph of a type II superior labrum anterior and posterior (SLAP) tear as viewed from the posterior portal to the shoulder joint
Fig. 3
Fig. 3
Intraoperative arthroscopic photograph of prior patient with type II SLAP tear treated with a knotless suture anchor system
See this image and copyright information in PMC

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