Indications for Biceps Tenodesis in Injured Overhead Throwing Athletes Lack Consensus: A Systematic Review and
Aaron D Sciascia1, W Jeffrey Grantham2, Austin V Stone3
1Institute for Clinical Outcomes and Research, Lexington Clinic, Lexington, Kentucky, U.S.A.
Arthroscopy, Sports Medicine, and Rehabilitation
|July 22, 2025
Summary
Surgeons lack consensus on biceps tenodesis indications for throwing athletes. Diagnostic methods are inconsistently applied, with limited literature support for current clinical practices in biceps tendon surgery.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Shoulder Arthroscopy
Background:
- Biceps tenodesis is a common procedure for injured overhead throwing athletes.
- Current clinical practices and indications for biceps tenodesis lack a clear consensus.
Purpose of the Study:
- To evaluate current clinical practice methods for biceps tenodesis.
- To identify reported indications for biceps tenodesis in injured overhead throwing athletes.
- To establish a consensus for clinical practice regarding biceps tenodesis indications.
Main Methods:
- Combined a survey of experienced shoulder surgeons with a systematic review of relevant literature.
- Identified preoperative and intraoperative factors used to establish biceps involvement.
- Analyzed 11 studies involving 249 overhead throwing athletes.
Main Results:
- Survey responses indicated a similar thought process for tenodesis but lacked literature support for several aspects.
- Inconsistent use of diagnostic components was observed, with few history or physical exam elements selected by a majority of surgeons.
- Literature review revealed a lack of consensus on diagnostic elements for identifying biceps involvement.
Conclusions:
- The reasoning process for biceps tenodesis indications is incompletely supported by current literature.
- There is no consensus on specific history or physical examination components for diagnosing biceps involvement.
- A lack of consensus exists regarding diagnostic elements integral to establishing biceps involvement in injured throwing shoulders.
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