Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Aug;15(8):1967-1974.
doi: 10.1111/os.13534. Epub 2022 Dec 2.

The Correlation between Variation of Labral Attachment and Lesions of the Long Head of the Biceps Tendon in Patients with Rotator Cuff Tears

Yi Lu  1 , Yue Li  1 , Hailong Zhang  1 , Xu Li  1 , Fenglong Li  1 , Chunyan Jiang  1
Affiliations

The Correlation between Variation of Labral Attachment and Lesions of the Long Head of the Biceps Tendon in Patients with Rotator Cuff Tears

Yi Lu et al. Orthop Surg. 2023 Aug.

Abstract

Objective: There was no universally accepted classification system that describes LHBT lesions as a type of its' pathology in patients with shoulder pain. This study aimed to determine the correlation of anatomic variants of glenoid labrum attachment of long head of biceps tendon (LHBT) and to assess their association, if any, with its lesions in rotator cuff tear (RCT) patients.

Methods: All RCT patients from January 2016 to December 2019 were assessed arthroscopically to classify the LHBT labrum attachment according to its' anatomical location. A simplified classification was created to describe the LHBT as normal, tendinitis, subluxation or dislocation, partial tear and superior labral tear from anterior to posterior (SLAP) lesion beyond type II The RCT were classified as three types as partial, small to medium and large to massive. The correlation of variants of LHBT labral attachment with type of LHBT lesions in different RCT groups was evaluated.

Results: In total, 669 patients were included for evaluation. The attachment of the LHBT was entirely posterior in 23 shoulders (3.4%), posterior-dominant in 81 shoulders (12.1%), and equal in 565 shoulders (84.4%). In equal distribution LHBT attachment group, age > 60 (odds ratio: 2.928, P < 0.001) and size of RCT (P < 0.001) were significant risk factors of LHBT lesions. In the analysis of all patients, comparing with the partial thickness rotator cuff tear (PTRCT), the odds ratio of small to medium RCT and large to massive RCT was 2.398 and 6.606 respectively. In addition, age > 60 (odds ratio: 2.854, P < 0.001) and size of RCT (P < 0.001) were significant risk factors of LHBT lesions. In posterior dominant group, size of RCT was a significant risk factor of LHBT lesions but not any others (P < 0.001). In entirely posterior group, no risk factor of LHBT lesions was found. It showed that the variation of LHBT attachment was not a significant risk factor of LHBT lesions in rotator cuff repaired patients (p = 0.075).

Conclusions: There are three types of LHBT labrum attachment in RCT patients on arthroscopic observation. 84.4% were equal distribution of LHBT attachment on glenoid labrum, followed by posterior-dominant (12.1%) and entirely posterior type (3.4%) in present study. Although the variation of LHBT attachment was not a significant risk factor of LHBT lesion in rotator cuff repaired(RCR) patients, there were different risk factors among three LHBT labral attachment types. In RCR patients, age > 60 and RCT size were significant risk factors of LHBT lesions.

Keywords: Arthroscopic; Biceps; Labrum Attachment; Rotator Cuff.

PubMed Disclaimer

Conflict of interest statement

All authors are without conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject of this manuscript.

Figures

Fig. 1
Fig. 1
Entirely posterior type of LHBT labrum attachment of left shoulder: (A) diagram; (B) arthroscopic view with the camera through the posterior portal in glenoid humeral joint; (C). arthroscopic view with the camera through the anterior‐lateral portal in subarcromial space
Fig. 2
Fig. 2
Posterior‐dominant type of LHBT labrum attachment of left shoulder: (A) diagram; (B) arthroscopic view with the camera through the posterior portal in glenoid humeral joint; (C) arthroscopic view with the camera through the anterior‐lateral portal in subarcromial space
Fig. 3
Fig. 3
Equal type of LHBT labrum attachment of left shoulder: (A) diagram; (B) arthroscopic view with the camera through the posterior portal in glenoid humeral joint; (C) arthroscopic view with the camera through the anterior‐lateral portal in subarcromial space
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Hitchcock HH, Bechtol CO. Painful shoulder; observations on the role of the tendon of the long head of the biceps brachii in its causation. J Bone Joint Surg Am. 1948;2:263–73. - PubMed
    1. Neer CSII. Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am. 1972;1:41–50. - PubMed
    1. Chen XT, Fang W, Jones IA et al. The efficacy of platelet‐rich plasma for improving pain and function in lateral epicondylitis: a systematic review and meta‐analysis with risk‐of‐bias assessment. Art Ther 2021, 9: 2937–2952. - PubMed
    1. Becker DA, Cofield RH. Tenodesis of the long head of the biceps brachii for chronic bicipital tendinitis. Long‐term results. J Bone Joint Surg Am. 1989;3:376–81. - PubMed
    1. Gigis P, Natsis C, Polyzonis M. New aspects on the topography of the tendon of the long head of the biceps brachii muscle. One more stabilizer factor of the shoulder joint. Bull Assoc Anat (Nancy). 1995;245:9–11. - PubMed