Biceps Tenodesis

Biceps Tenodesis

Surgical treatment from highly-qualified Adelaide-based orthopaedic surgeons

Biceps tenodesis is a surgical procedure treating painful biceps tendon injuries and conditions. Here, the surgeon detaches the biceps tendon from its original attachment in the shoulder and reattaches it to the humerus.

This surgery aims to improve stability, relieve pain, restore function, and eliminate biceps tendon-related symptoms, increasing a patient’s quality of life.

When is biceps tenodesis performed?

Biceps tenodesis is typically performed in the following situations:

Biceps tendon injury or tear: When the biceps tendon is partially or completely torn or damaged, causing pain, weakness, or instability in the shoulder, biceps tenodesis may be recommended.

Biceps tendon-related pain: If conservative treatments, such as rest, physical therapy, or medication, have not relieved chronic pain originating from the biceps tendon, biceps tenodesis may be considered.

Biceps tendon instability: In cases where the biceps tendon is dislocating from its normal position, causing recurrent symptoms or affecting shoulder function, biceps tenodesis can help stabilise the tendon and prevent further instability.

Concurrent shoulder procedures: Biceps tenodesis may be performed in conjunction with other shoulder surgeries, such as rotator cuff repairs or shoulder instability repairs, to optimise shoulder function.

What does an orthopaedic evaluation involve?

If you are experiencing symptoms related to the biceps tendon, you may be referred to an orthopaedic surgeon for an orthopaedic evaluation. Specialists at Adelaide Shoulder & Upper Limb Clinic consult from numerous convenient locations in Adelaide and its surrounds.

During an orthopaedic evaluation, the surgeon will perform several assessments and examinations to gather information about your biceps tendon condition. The process generally includes:

  • Review of medical history: This includes any previous injuries, surgeries, or medical conditions relevant to your biceps tendon fracture.
  • Physical examination: The surgeon will examine your shoulder and arm, assessing for signs of biceps tendon injury. This may include palpation of the affected area, checking for tenderness, evaluating range of motion, and assessing strength and stability.
  • Testing: Testing may include ultrasounds, CT scans, MRI scans, and blood tests.
  • Functional assessment: The surgeon may evaluate how the biceps tendon condition is affecting your daily activities, such as reaching, lifting, or performing shoulder movements.

Based on the information gathered from the evaluation, the orthopaedic surgeon will discuss the diagnosis, treatment options, and recommendations for your biceps tendon condition.

Preparing for biceps tenodesis surgery

Before surgery, your orthopaedic surgeon may request medical tests, evaluations, and appointments to assess your health and identify any risks that may affect the surgery.

Discontinue usage of certain medications before your surgery, and fast for eight hours pre-procedure. Your surgeon will provide specific instructions. You may need to make lifestyle adjustments, such as quitting smoking, refraining from alcohol, or changing your diet and exercise routine.

Organise transportation to and from the surgical facility, and consider arranging for someone to assist you at home during the initial recovery period. Make necessary arrangements at home to ensure a comfortable and safe recovery. This may include rearranging furniture, creating a recovery area, and purchasing essentials such as medications, ice packs, and loose-fitting clothing.

Contact your surgeon or their team with any concerns or questions before the surgery. They can provide specific guidance based on your individual situation and address any preoperative anxieties.

What happens during biceps tenodesis?

During a biceps tenodesis procedure, the surgeon reattaches the biceps tendon to the upper arm bone (humerus) in a new location.

You will be administered general anaesthesia to ensure you are comfortable and pain-free during the surgery. Then, the surgeon will make one or more small incisions in the shoulder area to access the biceps tendon and the surrounding structures. Arthroscopic methods (where a small incision is made and a specialised camera is inserted for visualisation) will be implemented wherever possible.

The surgeon will detach the biceps tendon from its original attachment point within the shoulder joint. Then, they will prepare the biceps tendon for reattachment by removing any damaged tissue or frayed ends.

A new attachment site is created for the biceps tendon on the humerus bone. This can be done by drilling a hole or using special anchors, sutures, or screws. The biceps tendon will be secured to the newly created attachment site using fixation techniques.

Once the tendon is reattached correctly, the surgeon will close the incisions with stitches or staples. Sterile dressings or bandages will be applied to protect the surgical site.

What to expect after biceps tenodesis surgery

Most patients can return home the same day, but an overnight stay may be required in some cases. If your surgeon recommends an overnight stay, bring the required personal items.

It is common to experience pain, swelling, and discomfort in the shoulder region after surgery. Your healthcare team will prescribe pain medications to manage your discomfort during the initial stages of recovery.

You will likely need to wear a sling to restrict movement and protect the healing shoulder. Usage is generally recommended for three weeks post-surgery.

Initially, you will have limited use of the affected arm as the tendon heals. Your surgeon will prescribe a rehabilitation program that includes exercises to regain range of motion, strengthen the biceps tendon, and improve functional abilities.

Follow-up appointments will be scheduled to monitor your progress, remove stitches or staples, assess healing, and adjust your treatment plan if necessary. Attend all scheduled appointments and communicate any concerns.

The recovery timeline can vary from person to person. Generally, it takes four to six months to fully recover from biceps tenodesis surgery, but individual factors and the nature of the injury can influence this duration.

Recovering after biceps tenodesis

First two weeks following surgery

You will wear a sling for the first three weeks after surgery. You may experience pain and discomfort, which can be managed with prescribed pain medications.

Rest the shoulder and avoid strenuous activities as instructed by your surgeon. Follow guidelines for incision care, keeping the area clean and dry and attending a follow-up appointment for the removal of stitches or staples.

Two weeks later

Your surgeon or physical therapist will introduce gentle range-of-motion exercises to prevent stiffness and promote healing. You may be able to return to work if your responsibilities require light arm and shoulder movements only.

Six weeks later

Physical therapy will include exercises to improve the strength and function of the shoulder and surrounding muscles. With your surgeon’s approval, you may gradually resume everyday activities and movements, including driving.

Three months later

By this point, you should experience an improved range of motion and increased strength in your shoulder. You should be able to resume most daily activities, but high-demand activities or sports are still restricted.

Six months later

You can expect a near-complete recovery with a significantly improved range of motion, strength, and functionality. You may gradually reintroduce sports-specific activities or more demanding movements under the guidance of your healthcare team.