Long head of the biceps tendon ruptures treatment:  literature review

Ignas Floreskul1, Dainius Misevičius1, Jokūbas Vitkus1

1 Lithuanian University of Health Sciences, Academy of Medicine, Kaunas, Lithuania


The long head of the biceps tendon is a common site of anterior shoulder pain. The complex anatomical position often causes ruptures associated with rotator cuff lesions. These ruptures require clinical evaluation and appropriate treatment. When conservative treatment is not possible, two main surgical procedures are chosen: tenotomy and tenodesis. Both of these methods achieve effective clinical results, although in clinical practice there is still a dilemma in choosing one of them. Tenodesis is technically more complex and, even though it requires longer rehabilitation, does not cause cosmetic defects. Tenotomy is simpler, faster, and less invasive.

Aim: evaluation of the advantages of tenodesis and tenotomy by analyzing clinical outcomes.

Methods: the search of literature sources was carried out using these databases: Pubmed, UpToDate, Medline and ScienceDirect. Used keywords: „biceps“, „tenotomy“, „tenodesis“, „rotator cuff“, „long head of the biceps tendon“, „rotator cuff injuries“, „shoulder“. The newest articles, representing the topic were analyzed. The article provides a comprehensive review of the analyzed literature on biceps long tendon treatment by tenodesis and tenotomy methods.


  1. In majority of the literature reviewed, the results of ASES, CMS, and VAS do not differ between both tenotomy and tenodesis.
  2. The most important difference is the Popeye deformation, which was statistically more common after tenotomy in all the literature reviewed.
  3. The flexion and rotation force of the forearm also did not differ between the outcomes of the two surgical treatments in most of the studies.

Keywords: tenodesis, tenotomy, rotator cuff, biceps.