Biceps Tenotomy

Biceps Tenotomy

Shoulder Surgery - Adelaide Orthopaedic Specialist

Biceps tenotomy may be used to release a damaged long head tendon, reducing pain. The specialists at Adelaide Shoulder & Upper Limb Clinic are able to provide this procedure using a minimally-invasive arthroscopic approach.

What is a biceps tenotomy?

The biceps muscle has two tendons which attach it to the labrum. While the larger (short head) tendon rarely causes problems, the long head tendon is prone to wear and tear. If it becomes frayed, painful or degenerate, a biceps tenotomy can be performed to reduce pain by releasing it from its anchor point at the shoulder. Biceps tenotomy may also be performed to treat a SLAP lesion or tear.

Alternatives to biceps tenotomy

A biceps tenotomy may be performed as an alternative to biceps tenodesis, which involves severing the tendon and reattaching it below the pectoralis major muscle. The main difference in outcomes is cosmetic: by anchoring the tendon to a new point (rather than letting it hang freely), the risk of Popeye deformity to the biceps muscle is reduced.

What is involved in an arthroscopic biceps tenotomy?

In a biceps tenotomy, the biceps tendon is cut free from the labrum and allowed to retract into the upper arm. It is not reattached to any structure in the shoulder, and is allowed to heal on its own.

The specialists at Adelaide Shoulder & Upper Limb Clinic are able to perform biceps tenotomy using an arthroscopic approach. This allows them to operate through a series of small incisions, rather than creating a large wound.

The arthroscopic approach to biceps tenotomy involves inserting a small camera into the joint to gain a clear view of the area. Specialised tools are then inserted through another small incision and used to release the tendon from its anchor point. The tools are then removed and the small wounds are stitched closed.

Surgical Outcomes

As biceps tenotomy involves releasing the long head tendon, change to the contour of the biceps muscle may occur. This often not noticeable; however, some patients may request an alternative procedure to avoid the risk of deformity.

The arthroscopic approach to biceps tenotomy has the advantage of causing minimal disruption to the surrounding tissue, which may result in a faster recovery time and reduced scarring.

In the majority of cases, there is no noticeable reduction in strength or motion following the procedure. Most patients who undergo biceps tenotomy report better use of the shoulder, less pain, and the ability to return to sports following the recovery period.

Recovery from biceps tenotomy

As there is no reattachment involved, recovery from biceps tenotomy tends to be quicker than recovery from biceps tenodesis.

Typically speaking, your shoulder will remain immobilised in a sling for four to six weeks post-procedure. This will be followed by specialised exercises to help restore movement and strength to the shoulder joint, and a gradual return to normal activity. However, your individual recovery process will be influenced by your own health and the nature of your condition.

Following your biceps tenotomy, you may experience occasional muscle cramping and spasms. This is particularly common following strenuous activities or repetitive turning motions, such as lifting weights or turning a screwdriver.