Biceps long tendon: Pain generator not requiring tenodesis in total shoulder arthroplasty

Since 2002, the long head of the biceps tendon has been identified as a pain generator following total shoulder arthroplasty, and routine tenodesis during shoulder replacement has been recommended by some to prevent pain. However, while randomized clinical trials directly investigating the impact of tenodesis on overall outcomes after arthroplasty are lacking, biomechanical and in vivo studies have provided evidence of an important stabilizing role of the long-head tendon that may be linked to better function post-arthroplasty. As a result, at this time routine tenodesis of the long-head tendon of the biceps is an unanswered question during shoulder arthroplasty procedures.