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
. 2025 Jan 23;5(2):160-169.
doi: 10.1016/j.xrrt.2024.12.013. eCollection 2025 May.

Surgical treatment of long head of biceps pathology: analyzing trends in the United States from 2010 to 2019

Jacob A Worden  1 , John M Kopriva  2 , Henry M Gass  2 , Zaamin B Hussain  2 , Anthony L Karzon  2 , Krishna N Chopra  2 , Michael B Gottschalk  2 , Eric R Wagner  2
Affiliations

Surgical treatment of long head of biceps pathology: analyzing trends in the United States from 2010 to 2019

Jacob A Worden et al. JSES Rev Rep Tech. .

Abstract

Background: The long head of the biceps tendon (LHBT) is a common cause of anterior shoulder pain. A symptomatic LHBT is commonly encountered in the setting of a rotator cuff tear. The purpose of this study was to determine trends in the incidence of isolated tenotomy and tenodesis procedures for symptomatic LHBT in the setting of rotator cuff repairs (RCR).

Methods: The MarketScan database was queried from 2010 to 2019 for biceps tenotomy (open) and tenodesis (open and arthroscopic) in the United States. Annual procedure volumes and incidences were calculated using discharge weights and U.S. Census Bureau data, respectively. Further subgroup analysis included age, gender, and region.

Results: Open tenodesis remained the most common procedure in the United States for isolated LHBT management. Its incidence increased by 180% from 2010 to 2019, accounting for 49% of isolated LHBT procedures by 2019. In the setting of RCR, arthroscopic tenodesis was most common, and its incidence grew by 138%. By 2019, arthroscopic tenodesis accounted for 58% of procedures in the setting of RCR, while tenotomy claimed only 2%. The incidence of all procedures increased for the age ≥65 cohort, with a notable 828% increase in the incidence of open tenodesis as an isolated procedure, accounting for 76% of procedures by 2019.

Conclusion: Volumes of procedures aimed to ameliorate LHBT pathology increased from 2010 to 2019. Open tenodesis remained the preferred procedure for isolated LHBT pathology, while arthroscopic tenodesis was preferred in the setting of concomitant RCR. Future research can develop algorithmic approaches to treating biceps pathology.

Keywords: Arthroscopic tenodesis; Biceps pathology; Superior labrum; Tenodesis; Tenotomy; Trends analysis.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Case volumes: open vs. arthroscopic isolated biceps tenodesis vs. isolated biceps tenotomy. BT, biceps tenodesis.
Figure 2
Figure 2
Procedure volumes over time: stratification of individual procedure volumes as a percentage of overall procedure volume. RCR, rotator cuff repair.
Figure 3
Figure 3
Procedure volumes by age: stratification of individual procedure volumes as a percentage of overall procedure volume. RCR, rotator cuff repair.
Figure 4
Figure 4
Procedure volumes by gender: stratification of individual procedure volumes as a percentage of overall procedure volume. RCR, rotator cuff repair.
Figure 5
Figure 5
Case volumes: open vs. arthroscopic tenodesis with rotator cuff repair vs. biceps tenotomy with rotator cuff repair. RCR, rotator cuff repair; BT, biceps tenodesis.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Abraham V.T., Tan B.H., Kumar V.P. Systematic review of biceps tenodesis: arthroscopic versus open. Arthroscopy. 2016;32:365–371. doi: 10.1016/j.arthro.2015.07.028. - DOI - PubMed
    1. Aflatooni J.O., Meeks B.D., Froehle A.W., Bonner K.F. Biceps tenotomy versus tenodesis: patient-reported outcomes and satisfaction. J Orthop Surg Res. 2020;15:56. doi: 10.1186/s13018-020-1581-3. - DOI - PMC - PubMed
    1. Belk J.W., Jones S.D., Thon S.G., Frank R.M. Trends in the treatment of biceps pathology: an analysis of the American board of orthopaedic surgery database. Orthop J Sports Med. 2020;8:6. doi: 10.1177/2325967120969414. - DOI - PMC - PubMed
    1. Chen C.H., Hsu K.Y., Chen W.J., Shih C.H. Incidence and severity of biceps long head tendon lesion in patients with complete rotator cuff tears. J Trauma. 2005;58:1189–1193. doi: 10.1097/01.ta.0000170052.84544.34. - DOI - PubMed
    1. Colvin A.C., Egorova N., Harrison A.K., Moskowitz A., Flatow E.L. National trends in rotator cuff repair. Bone Joint Surg Am. 2012;94:227–233. doi: 10.2106/jbjs.J.00739. - DOI - PMC - PubMed

LinkOut - more resources