Reinforcements and augmentations with the long head of the biceps tendon in shoulder surgery: a narrative review

The long head of the biceps tendon (LHBT) has recently emerged as a therapeutic option for various shoulder pathologies. Synthetic materials and allografts have not shown sufficient resistance or favorable outcomes to restore rotator cuff native tissue properties, leading to consideration of using LHBT as biological augmentation. LHBT mimics adjacent structures, such as the rotator cuff, is easily accessible during surgery, and is a good source of live autologous cells for regenerative augmentation in rotator cuff repair, as a superior capsular reconstruction in irreparable cuff tears, in subscapularis augmentation in shoulder replacement and as a stabilizer in anterior shoulder instability. This narrative review aims to collect, synthesize and critically evaluate the literature on the use of the LHBT and its current applications in the field of shoulder surgery, improving the understanding of the terminology and consolidating the concepts related to the various procedures in shoulder surgery.