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Disorders and injuries of the biceps tendon and limbus (joint meniscus)

Many disorders or injuries of the limbus or biceps tendon can now be treated by arthroscopy. This means that the integrity of the surrounding soft tissues is largely preserved. However, a diseased or injured biceps tendon cannot usually be reconstructed, but rather is separated at the biceps anchor, at the junction with the limbus, and refixed in the tendon channel on the humeral head. By contrast, the detached limbus at the upper edge of the joint can be refixed by arthroscopy.

Follow-up management is based not on a standard regimen, but on the specific circumstances of the individual patient. Generally, however, these cases involve a 2-3-month period of rehabilitation, and sporting activities cannot be resumed until at least three months after the operation. There remains the question as to whether such lesions should be surgically managed at all. Not everything that can be reconstructed necessarily requires an operation. In my own case, I consider that surgery is indicated only when physiotherapy has failed and the symptoms persist. The patient's suffering or physical limitations at work and when exercising are crucial factors in this decision.

The spontaneous progression of the damage may lead to an increase in pain and restriction of movement on the one hand or to a new equilibrium with fairly minimal impairment of well-being on the other. For the above reasons, the decision to operate should not be made too quickly.