Biceps Tenodesis
Tears of the long head of the biceps tendon can cause a loss of strength and pain and may appear as deformity of the arm called Popeye deformity. This deformity is the result of a detached biceps tendon that allows the biceps muscle to bunch up on the upper arm. Tendinopathy refers to any injury to the biceps muscle tendon caused by overuse or trauma.
How are biceps tendon tears treated?
Nonsurgical/conservative treatment includes rest, icing, over the counter pain medications, activity modification, physical therapy, and cortisone injections to help relieve pain. When conservative management fails to relieve pain and restore strength, surgery may be recommended. When the patient is a young athlete who suffers an injury that causes inflammation and tearing surgery will be recommended.
What is tenodesis?
Biceps tenodesis is surgical repair of symptomatic tendon tears. The goal is to treat shoulder pain caused by inflammation and degenerative disease of the biceps tendon. Tenodesis is often combined with other necessary surgical procedures such as rotator cuff tear repairs. Complications are rare.
Who is a candidate for tenodesis?
Patients who have:
An acute rupture (tear) of the long head of the biceps tendon
a SLAP tear of the labrum (the cartilage that lines the shoulder socket) that occurs where the biceps tendon attaches to the labrum
biceps tendonitis - inflammation
biceps tendinosis - degenerative disease caused by overuse and aging wear and tear.
What is the procedure?
Tenodesis is surgery performed under general anesthesia. Tenodesis may be performed as minimally invasive arthroscopic surgery. If other shoulder surgery is necessary tenodesis may be performed during open surgery.
During the procedure Dr. Johnston will insert an arthroscope into the shoulder to view inside the joint and confirm the diagnosis of a tear, reveal tear details, and evaluate damage to other parts of the shoulder including the rotator cuff.
Minimally invasive arthroscopic surgery involves the creation of a small opening in the shoulder to insert the arthroscope into the joint. Then a small hole is made in the upper arm bone and using tiny instruments the tendon is trimmed or detached and reattached to the upper arm bone with screws and an anchoring device or sutures.
Recovery from tenodesis
You will wake from surgery with your arm in a sling. Mobility exercises are begun early in recovery, but full range of motion is restricted for at 6 weeks to allow the repairs to heal.
Recovery usually takes about three to six months unless other surgical procedures are performed with tenodesis. Full recovery can take up to 12 months.
Return to play after biceps tenodesis for SLAP tears
Overhead throwing is a common cause of biceps tendon tears. Biceps tenodesis is the preferred surgery procedure for repair of SLAP lesions in the elite overhead athlete. It encourages functional outcomes and return to sports rates even in the recreational athlete.
Tenodesis is a very successful operation for eliminating pain and improving shoulder function. It is most effective when performed within three months of the initial injury.
Dr. Peter Johnston is a board - certified shoulder and elbow specialist committed to compassionate, personalized care for his patients in Maryland and around the nation. He was trained by the world leaders in shoulder surgery. When you or a loved one suffers with a shoulder injury, contact Dr. Johnston to schedule a consultation.
