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
. 2024 May 29;4(3):26350254231222030.
doi: 10.1177/26350254231222030. eCollection 2024 May-Jun.

Descriptive Analysis of the Long Head of the Biceps Abnormalities in Distal Isolated Supraspinatus Tears Based on Video Records: A Study From the SFA Biceps Study Group Using the "Biceps Box" Concept

Johannes Barth  1   2 , Julien Berhouet  3 , David Gallinet  4 , Maxime Antoni  5 , Franck Dordain  6 , Nicolas Bonnevialle  7 , Jacques Guery  8 , François Gadea  9 , Adrien Jacquot  10 , Christophe Charousset  11
Affiliations

Descriptive Analysis of the Long Head of the Biceps Abnormalities in Distal Isolated Supraspinatus Tears Based on Video Records: A Study From the SFA Biceps Study Group Using the "Biceps Box" Concept

Johannes Barth et al. Video J Sports Med. .

Abstract

Background: Considering the long head of biceps (LHB) management, important cultural differences exist among the surgeons around the world, especially when repairing small isolated distal supraspinatus tears under arthroscopy. In the perspective of an international survey to analyze our practice regarding biceps management in small rotator cuff tears, the aim is to collect all the possible LHB abnormalities according to literature review, before considering that the LHB could be normal or pathologic.

Indications: The SFA (Société Francophone d'Arthroscopie) behind its research biceps group summarized these abnormalities in a description analysis called the "biceps box" concept, which was validated with a strong inter-rater reliability. The aim is to present the description analysis using a common language with short video records for each abnormality described to reproduce "intraoperatively" the different possible scenarios the surgeon has to encounter during arthroscopic evaluation.

Technique description: The description of the "biceps box" concept classifies lesions of the LHB, with so-called intrinsic lesions, for which the LHB should be considered pathological: partial rupture or delamination, fissuring, lateral or medial instability or subluxation, hypertrophy with an hourglass figure; and so-called extrinsic lesions, for which the LHB should be considered healthy: damage to the pulley without bicipital instability, exposure of the articular portion of the biceps by rupture of the supraspinatus tendon, inflammation of the superficial surface of the tendon, presence of type 1 or 2 superior labral anterior to posterior (SLAP) lesions, or a chondral print.

Results: We present the 10 possible scenarios with video records according to our description analysis.

Discussion/conclusion: The LHB could be considered as a pain generator in certain situations which are still not completely clear. The indication of biceps tenotomy or tenodesis depends on the interpretation of the surgeon of these abnormalities as a pathologic or a normal condition. The next step is to use these videos in an international survey to assess cultural differences regarding the management and eventually find a consensus regarding treatment options for each abnormality.

Patient consent disclosure statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

Keywords: arthroscopy; biceps box; extrinsic lesions; intrinsic lesions; long head of biceps lesion; shoulder; supraspinatus tears.

PubMed Disclaimer

Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: J. Barth receives royalties or licenses from SBM and Move Up; consulting fees from Arthrex, SBM, and Move Up; has participated on a data safety monitoring board or advisory board for SFA DataLake; was a past president of SFA; and has stock or stock options in BeeMed. J. Berhouet is a consultant for Stryker. D.G. receives royalties from and is a consultant for Move Up. M.A. is a consultant for FX Solutions. F.D. receives royalties from FX Shoulder Solutions and is a consultant for Zimmer and Biomet. N.B. receives royalties from and is a consultant for SBM and Move Up. J.G. receives royalties from and is a consultant for Move Up. A.J. is a consultant for Stryker and Arthrex. C.C. receives royalties from and is a consultant for Move Up. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Graphical Abstract
Graphical Abstract
This is a visual representation of the abstract.
See this image and copyright information in PMC

References

    1. Benhenneda R, Brouard T, Charousset C, Berhouet J. Can artificial intelligence help decision-making in arthroscopy? Part 2: the IA-RTRHO model—a decision-making aid for long head of the biceps diagnoses in small rotator cuff tears. Orthopaed Traumatol Surg Res. 2023;12:103652. doi: 10.1016/j.otsr.2023.103652. - DOI - PubMed
    1. Benhenneda R, Brouard T, Dordain F, Gadéa F, Charousset C, Berhouet J. Can artificial intelligence help decision-making in arthroscopy? Part 1: use of a standardized analysis protocol improves inter-observer agreement of arthroscopic diagnostic assessments of the long head of biceps tendon in small rotator cuff tears. Orthopaed Traumatol Surg Res. 2023;15:103648. doi: 10.1016/j.otsr.2023.103648. - DOI - PubMed
    1. Boileau P, Ahrens PM, Hatzidakis AM. Entrapment of the long head of the biceps tendon: the hourglass biceps—a cause of pain and locking of the shoulder. J Shoulder Elbow Surg. 2004;13(3):249-257. doi: 10.1016/j.jse.2004.01.001. - DOI - PubMed
    1. Boileau P, Baqué F, Valerio L, Ahrens P, Chuinard C, Trojani C. Isolated arthroscopic biceps tenotomy or tenodesis improves symptoms in patients with massive irreparable rotator cuff tears. J Bone Joint Surg. 2007;89(4):747-757. doi: 10.2106/JBJS.E.01097. - DOI - PubMed
    1. Boileau P, Maynou C, Balestro JC, et al. [Long head of the biceps pathology]. Rev Chir Orthop Reparatrice Appar Mot. 2007;93(8 suppl.):5S19-S553. - PubMed

LinkOut - more resources