Tendinopathy of the long head of the biceps tendon: histopathologic analysis of the extra-articular biceps tendon and tenosynovium

Open Access Journal of Sports Medicine
Jonathan J StreitReuben Gobezie

Abstract

Bicipital tendinitis is a common cause of anterior shoulder pain, but there is no evidence that acute inflammation of the extra-articular long head of the biceps (LHB) tendon is the root cause of this condition. We evaluated the histologic findings of the extra-articular portion of the LHB tendon and synovial sheath in order to compare those findings to known histologic changes seen in other tendinopathies. Twenty-six consecutive patients (mean age 45.4±13.7 years) underwent an open subpectoral biceps tenodesis for anterior shoulder pain localized to the bicipital groove. Excised tendons were sent for histologic analysis. Specimens were graded using a semiquantitative scoring system to evaluate tenocyte morphology, the presence of ground substance, collagen bundle characteristics, and vascular changes. Chronic inflammation was noted in only two of 26 specimens, and no specimen demonstrated acute inflammation. Tenocyte enlargement and proliferation, characterized by increased roundness and size of the cell and nucleus with proteoglycan matrix expansion and myxoid degenerative changes, was found in all 26 specimens. Abundant ground substance, collagen bundle changes, and increased vascularization were visualized in all samples. A...Continue Reading

Citations

Nov 29, 2015·Clinics in Sports Medicine·Ryan M CarrReuben Gobezie
Feb 28, 2016·Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association·Sarah B NossovJames E Carpenter
Jul 7, 2019·Journal of Orthopaedics and Traumatology : Official Journal of the Italian Society of Orthopaedics and Traumatology·Mohsen Mardani-KiviKhashayar Saheb-Ekhtiari
Sep 30, 2018·Molecular and Cellular Biochemistry·Finosh G ThankamMatthew F Dilisio

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