Biceps Tenodesis

Candidates for Biceps Tenodesis include individuals experiencing ongoing shoulder pain despite conservative treatments, such as physical therapy or corticosteroid injections. It’s often recommended for patients who have biceps tendonitis, a SLAP tear (a type of labrum tear), or other conditions affecting the biceps tendon.

Biceps Tenodesis can be performed as an open procedure or arthroscopically, each with slightly different processes:

Open Biceps Tenodesis:

• Your shoulder surgeon Dr. Mayo starts the procedure arthroscopically, with two tiny incision around the shoulder to release the biceps from its attachment on the labrum
• Another small incision is then made on the front of the shoulder near the armpit
• The long head of the biceps tendon is identified, and then anchored to the humerus bone with sutures and a fixation device like an anchor or button to allow it to heal in the new position.

Arthroscopic Biceps Tenodesis:

• In this procedure, Dr. Mayo makes several small incisions are made around the shoulder.
• Using an arthroscope for visualization, the surgeon releases the biceps tendon from its original attachment on the labrum
• A small hole is drilled into the humerus, and the tendon is anchored into this hole using sutures and an anchor or button

In both methods, the goal is to stabilize the biceps tendon, alleviating pain and preventing further damage.

Patients can often return to light work or desk jobs within 1-2 weeks following surgery. A return to heavy lifting or sports typically takes around 4-6 months, as it takes time for the tendon to fully heal into its new location and to rebuild strength.

You will wake up with your shoulder in a sling to help immobilize the arm and aid in the healing process. After recovering from anesthesia, you will go home an hour or two after surgery. Pain and discomfort can be expected, and your shoulder surgeon Dr. Mayo will prescribe pain medications to manage this.

Physical therapy is crucial to restore shoulder strength and flexibility:

Early Stage (Weeks 1-4): Goals are to manage pain, prevent shoulder stiffness, and begin gentle range-of-motion exercises under the guidance of a physical therapist.

Middle Stage (Weeks 4-12): As healing progresses, the physical therapist will introduce more advanced range-of-motion exercises and light strengthening exercises.

Late Stage (Weeks 12 and beyond): This phase focuses on regaining full strength and movement. You’ll be guided through more challenging exercises to prepare you for a return to regular activities.

Potential risks, although rare, include:

• Infection: Occurs in less than 1% of patients. Antibiotics are administered around the time of surgery to minimize this risk.
• Nerve injury: While rare, there’s a small risk of nerve injury, which could cause permanent or temporary weakness or numbness in the arm.
• Cosmetic changes: Some patients might notice a small but permanent bulge or change in the contour of the biceps muscle, commonly referred to as a “Popeye” muscle.
• Failure of the tenodesis: There’s a chance the tendon could fail to heal properly in its new location, which might require additional surgery.

If your shoulder surgeon Dr. Ben Mayo recommends Biceps Tenodesis and you decide not to have surgery, potential risks include:

• Ongoing pain and discomfort: Without treatment, the irritation and inflammation caused by the damaged biceps tendon may continue.
• Decreased shoulder function: Chronic pain and discomfort may limit your ability to perform everyday activities or participate in sports.
• Further damage to the shoulder: Continued wear and tear on the biceps tendon could lead to further shoulder joint damage.