Introduction: Traumatic ruptures of the Biceps tendon are rare, but serious, and usually involve the long head of the proximal insertion. Rupture of the distal tendon account for only 3% of all Biceps tendon ruptures. A history of tendonitis, overuse, or anabolic steroid abuse may predispose tendons to rupture. Surgical repair, followed by a comprehensive rehabilitation program, was indicated to regain full strength and the range of motion in both flexion and supination. Frequency of the distal tendon rupture occurs between the age of 40 and 60. This kind of disease is more frequent in men than in women.Cases report: A 36 -year-old male weight lifter sustained a rupture of the distal Biceps tendon during lifting a heavy weight .The athlete denied any history of tendonitis or anabolic steroid use. He felt a pop sound in his left arm and also an extreme pain plus decreasing the muscle strength. The patient wasn't able to bow his elbow or to turn it outwards in elbow joint area. After physical examination and taking MRI, he was diagnosed and verified by the test for traumatic ruptures of the Biceps tendon. Immediately he was operated with a surgical repair using modified Boyd-Anderson and Muscle Splitting Model with two incision, then his left arm was placed in a cast for 6 weeks. Six months after surgery and physical therapy. He regained full range of motion and strength. After that he was released to lift weight without restrictions. Conclusion: This study shows exactly when a surgical intervention in order to repair a ruptured distal Biceps tendon is necessary, appropriate conservative measures can be taken to allow the surgery to be delayed without any harm against the patient. The athletic trainer should be aware of how to recognize and how to treat this injury at once.

Objective: To evaluate the clinical and radiographic findings of long head Biceps tendon (LHBT) transfer in traumatic proximal humeral fractures with the Biceps groove breakage or comminution. Methods: In this interventional study, subjects surveyed in terms of shoulder function, clinical signs of LHBT tendinitis, radiographic signs of transferred Biceps as a possible depressor of the shoulder, and mechanical changes of the scapula. Data were analyzed in SPSS version 21. Results: Fifteen patients were included in the case group (tendon transfer to the conjoined tendon), and 10 patients were evaluated in the control group (non-transfer or non-manipulation of the exposed tendon in the fracture callus of Biceps groove). The mean age of the study population was 46. 56±, 14. 31 years, and the majority of patients (14. 56%) were men. The differences between two groups were not significant in terms of the American Society of Shoulder and Elbow Surgeons (ASES) score, University of California at Los Angeles (UCLA) score, and constant shoulder score (CSS) (p=0. 535, p=0. 419, and p=0. 266, respectively). Also, there was no significant differences between the case and control groups regarding the Biceps muscle involvement (Popeye sign: p=1. 00,tenderness: p=0. 477,pain: p=1. 00,speed test: p=1. 00,Yergason’, s test: p=1. 00). Conclusion: LHBT transfer to the conjoined tendon in proximal humerus fractures with cleavage or comminution at the bicipital groove showed no advantages.

Bone And Site Hold tendon Inside (BASHTI) implant-less technique is proposed as an alternative to conventional tendon repair methods. This study aims to evaluate the strength of this technique under Biceps loading conditions with different fixation strategies. Twelve specimens with bovine tendons and Sawbones were constructed using two different insertion methods,in Group 1, 4 samples were prepared using a hand-hammer with a hitting frequency of 300 Beats Per Minute (BPM), while Group 2 included eight specimens with insertion using an auto-hammer applying a frequency of 3600 BPM. Both of the groups were tested under cyclic loading, followed by a pull-out until the failure. All the samples completed the cyclic step without failure. At the pull-out step, for Group 1, the strength and stiffness were 251 31 N and 10: 3 0: 8 N/mm, respectively, while these values were 183, 35 N and 10: 5, 3: 0 N/mm, respectively, for Group 2. It was concluded that the BASHTI structure for Biceps tendon reconstruction had a proper strength and the insertion process had no effect on its behavior under cyclic loading. It was also proved that variations in the insertion frequency significantly affected the maximum strength of the structure (pvalue = 0. 038). Still, its influence on the stiffness was insignificant (p-value = 0. 91).

Background and Aims The tendon of the Biceps long head is one of the most important causes of shoulder pain and often plays a multifactorial role in subacromial impingement syndrome. The present study aimed to determine the effect of kinesiotape application on the tendon thickness of the Biceps long head, pain, and proprioception of shoulder joint in athletes with subacromial impingement syndrome.Methods In this quasi-experimental study, 20 male athletes with subacromial impingement syndrome were selected purposefully and conveniently. The subjects were randomly assigned to two groups: group 1 received a real kinesiotape, and group 2 received a sham kinesiotape. tendon thickness of the Biceps long head was measured by MRI, shoulder proprioception was measured by an imaging technique, and the pain was measured by visual analog scale (VAS) immediately and 24 hours after using kinesiotape. The Shapiro-Wilk test was used to determine the normality of the distribution, and repeated measures analysis of variance was used to compare the mean differences between the two groups. The significance level was set at P<0.05.Results There were no significant differences in the thickness of the Biceps tendon between the two groups in the three stages of measurement (P=0.147). There was a significant difference between the two groups regarding the joint position sense at 45 degrees (P<0.001), but there was no significant difference at 90 degrees (P˃0.05). There was a significant difference between the pain scores of the two groups after the kinesiology tape application (P<0.001).Conclusion Kinesiotape can reduce pain and improve the proprioception sense in athletes with subacromial impingement syndrome.

Background: The aim of this study was to evaluate the factors influencing patient reported outcome measures (PROM) of Biceps tenodesis after the rupture of proximal long head of the Biceps tendon. Methods: Retrospective chart review was conducted to identify patients with complete proximal rupture of the long head of the Biceps that underwent Biceps tenodesis between 2002-2017. This yielded 42 patients, of which 23 (55%) completed the PROMIS Pain Interference, PROMIS Upper Extremity, Quick DASH, and a custom Biceps tear questionnaire, at a median of 8. 5 years (IQR: 5. 2-12) post-operatively. The median age of the respondents was 57 years (IQR: 43-61). The majority of patients (n=12, 52%) underwent tenodesis using suture anchor fixation, while the remaining underwent tenodesis with interference screw technique (n=6, 26%), key hole technique (n=1, 4. 3%), or tunnel technique (n=1, 4. 3%). A bivariate analysis was performed to evaluate factors influencing the PROMs. Results: Six patients (27%) reported persistent Biceps cramping at a median of 8. 2 years post-operatively, negatively impacting PROMs, and this was associated with older age. Six patients (27%) had post-operative complications, including infection, pain, stiffness, and re-rupture, of which four patients (17%) underwent reoperation. Patients with activity/sports-induced injury or those that underwent tenodesis using a suture anchor technique demonstrated better PROMs. Conclusion: Post-operative Biceps cramping persists in almost one-third of patients and significantly impacts PROMs. Patient activity level and the use of suture anchor technique for tenodesis were independent predictors of improved Biceps tenodesis outcome scores.

The tendon is a firm fibrous band of connective tissue that connects muscle to bone. This structure has the ability to transfer mechanical forces resulting from muscle contraction to the skeletal system. Tendinitis is a general term, often used to describe painful tendon situations due to constant stretching, overuse, degeneration, or poor tendon biomechanism. Tendinopathy is often the result of useless attempts by the body to regenerate a tendon, which a pathological conflict has led to a malfunction. Various treatments have been used to manage tendon disorders. Stem cells are divided into two categories. Embryonic cells (which are very potential but due to ethical considerations, limited studies have been done on them) and postnatal cells. Postnatal cells are divided into two categories, which include,Hematopoietic stem cells and mesenchymal stem cells. Mesenchymal stem cells have the ability to differentiate into multiple cells, including tenocytes, chondrocytes, and fibroblasts. these cells are a potential alternative to treating tendon lesions. This article presentan overview of the structure, biomechanics and disorders of tendon and, while pointing to the common therapies today, introduces stem cells, retrospective studies and possibility of using these cells in the optimal treatment of tendon disorders.

Among the flexor tendons in the horse's limbs, the superficial digital flexor tendon is more prone to damage than the deep digital flexor tendon. SDF tendonitis is a common injury in event horses. Recovery of superficial digital flexor tendon (SDFT) injuries is slow, but re-injury is likely. SDF tendon injuries are more common in the forelimb. Flexor tendon injuries are due to strain on the tendon or a direct trauma. tendon damage vary from inflammation and pain to complete rupture of the tendon. Injuries caused by strain are associated with swelling that require ultrasound assessment to confirm the diagnosis. Treatment for these injuries includes anti-inflammatory treatment, which is initially followed by a rehabilitation program. In cases where drug treatment is not responsive, surgical procedures including tendon splitting and superior check ligament desmotomy can be used. In this study, we briefly review the tendonitis of the superficial digital flexor tendon, etiology, clinical signs, diagnosis, treatment and prognosis.

Background: Large defects in chronic Achilles tendon ruptures are difficult to rapair. The purpose of this study was to evaluate the clinical and functional outcomes following reconstruction of the chronic large gaps in Achilles tendon ruture using free semitendinosus interposition tendon grafting.Methods: In a case series study, eleven male patients with mean age of 30±4 years and average defect size of 8.31±1.96 cm in their old Achilles tendon underwent reconstruction during 6 years in a teaching hospital in Tehran-Iran. Ipsilateral semitendinosus free tendon graft was used for reconstruction. The cases were evaluated by Ankle-Hindfoot Scale of American Orthopaedic Foot and Ankle Society (AOFAS), and the Achilles tendon Rupture Score (ATRS) to with a mean follow-up of 25.36±3.3 months.Results: The pre-operative AOFAS and ATRS of 70.4±5.3 and 31.7±5.7 preoperatively improved to 91.8±4.8 and 88.7±4.2 values. The ankle dorsiflexion showed a significant decline-postoperative value of 13.5±4.2 degrees compared to preoperative of 17.2±3.9 degrees (p=0.04). All the cases except a professional athlete, returned to their previous activities.Conclusion: This technique offers good clinical and functional results in patients with large defects and is associated with no donnersite morbidity. We recommend this technique for the reconstruction of the chronic at ruptures in patients with over 6 cm defects.