Biceps Management in Rotator Cuff Disease

LHBT tendinopathy is frequently encountered during the treatment of rotator cuff tears. Persistently symptomatic, or structurally abnormal/unstable LHBT may necessitate surgical treatment. Biceps tenotomy remains a viable option. Biceps tenodesis, when appropriate, may be performed through an arthroscopic intra-articular, high-in-the-groove approach, suprapectoral approach, or an open subpectoral approach with data supporting each technique. Biological augmentation of the rotator cuff using the LHBT or anterior cable reconstruction of the LHBT are promising alternative uses for the LHBT to decrease the incidence of large rotator cuff re-tears.