Bicep Tenodesis
What is a Bicep Tenodesis?
Bicep tenodeses are minimally invasive procedures aiming to restore the fragile connection between the biceps brachii (biceps muscle) and the shoulder. More specifically, the biceps long head attaches to the superior aspect of the glenoid fossa (shoulder socket) and the biceps short head attaches to the coracoid process of the shoulder blade. In surgery candidates, the procedure will involve removing the damaged biceps tendon (usually from long head) from the labrum (cartilage) lining the shoulder socket. Afterwards, the surgeon will reattach the biceps tendon to the humerus (upper arm bone). The surgeon may choose an open or arthroscopic approach depending on the patient’s age, severity of the injury and their activity levels.
Who needs a Bicep Tenodesis?
Patients with a torn biceps tendon are ideal candidates for the bicep tenodesis procedure. A biceps tendon may tear acutely or over time chronically, and be torn partially or entirely. Patients regularly report pain, popping or snapping sounds in the anterior (front) shoulder, a “Popeye” bulge, and the inability to supinate their forearm so their palm faces upwards. Those playing sports with frequent overhead movements (baseball, swimming, tennis) and increasing age are primary risk factors for tearing the biceps tendon. Patients with humerus fractures may also require a bicep tenodesis. A surgeon may recommend this surgery if their symptoms were not managed by conservative treatments like cortisone injections, physical therapy and other anti-inflammatory medications. A surgeon will decide between using a “soft” or “hard” tissue techique, where they will suture the biceps tendon to bone or other shoulder ligaments with or without additional hardware (screws, wires, etc.).
More about Bicep Tenodeses...
Once a surgeon examines the shoulder joint, they may also treat SLAP (superior labrum, anterior to posterior) tears – a common and concomitant injury observed in biceps tenodesis patients. Those injuries may occur from excessive load on the arm and/or falling on an extended arm. A surgeon may also choose to perform a biceps tenotomy where they will not reattach the biceps tendon to the upper arm bone after removing it from the labrum. Bicep tenodeses are most successful when performed within 3 months of the initial injury.
Life after Bicep Tenodeses...
A bicep tenodesis is a complicated surgery with a prolonged recovery period. Over 90% of patients report improvement in their pain and mobility following this procedure. This surgery really requires the cooperation of the patient as they enter their near 6-month long recovery period and adhere to physiotherapy guidelines.