Surgery for Biceps Tendinosis/Tendinopathy
What is biceps tenodesis?
Biceps tenodesis is a surgery performed to alleviate the pain caused by biceps tendinosis. Arthroscopic surgery is a minimally invasive procedure where surgery is performed via a ‘keyhole’ approach through two or three small incisions using a piece of equipment which is a bit like a thin telescope (an arthroscope).
Do I need to have this surgery?
Biceps Tendonitis will usually resolve within one year. If the pain persists and is generally not relieved with time or cortisone injections, then a patient may consider surgery since it’s likely there are more problems in the shoulder. There is usually no rush on surgery. Until conservative measures are no longer providing a patient with adequate pain relief, particularly if a person is having trouble sleeping, getting dressed, doing their job or preventing them from doing what they want to do, then surgery is usually recommended. This procedure is recommended for patients who have partial or full-thickness biceps tendon tears, biceps instability, SLAP lesions, or biceps tendinopathy.Read more about biceps tendinitis here.
What happens during the surgery?
During your surgery you are generally sat up in a beach chair type position. The operation is usually done via keyhole surgery (arthroscopy). The surgeon introduces a camera into your shoulder through a small incision and watches the images on a TV screen. Photos are taken of the findings.
Biceps tenodesis is a procedure during which the surgeon cuts the attachment of the biceps tendon to the labrum (cartilage around shoulder socket) and reattaches it to the humerus (upper arm bone). The benefit of reattaching the tendon below the bicipital groove is restored function and decreased pain. Removing the painful part of the biceps usually resolves symptoms and restores normal function. After the surgery, the small wound is closed using stitches.
Will I feel any pain?
Your arm will feel numb because of the nerve block/local anesthetic used during your operation, but this should wear off during the first 24 hours after the operation. Post-operative pain is normal, and you will receive medication to help minimize this pain.
What are the risks?
As with any surgery, shoulder arthroscopy carries some risk, however, it has been shown to be safe with few complications.
Arthroscopic biceps tenodesis is routinely performed and is generally a very safe procedure. Before suggesting the operation, your doctor will have considered that the benefits of the procedure outweigh any disadvantages. However, to make an informed decision and give your consent, you need to be aware of the possible side effects and complications associated with most surgical operations.
Complications may include:
- Infection – this is a very serious complication and significant measures are taken to avoid it, for example you will be given antibiotics to try to guard against it.
- Nerve injury – the risk of this is very rare, but if damage occurs further treatment or surgery may be needed.
- Bleeding – this is rarely an issue as arthroscopic capsular release is a ‘keyhole’ procedure with very little blood loss.
- Thrombosis/blood clot – this is rarely an issue in shoulder surgery.
- Symptoms of stiffness may return – this is unusual, but it may become necessary to repeat the operation if the stiffness is troublesome.
Bicep tendon surgery has a high success rate. Nearly all patients experience less pain and more strength after the procedure. Small studies of arthroscopic tenodesis patients show that 90% of patients have an excellent recovery with minimal differences between arms.Is bicep tendon surgery worth it? ›
Surgeons seem to agree that the benefit of surgery is a little more supination strength, with flexion strength returning close to normal with or without surgery. An untreated rupture causes less deformity than with proximal biceps rupture. Surgery adds a scar and does not entirely prevent deformity.Will my bicep look the same after surgery? ›
Will my arm look the same after surgery and will I be able to regain full strength? Yes, the doctor will make sure the tension on the biceps is anatomically correct and will allow you to have symmetry and full strength after surgery once the muscle bulk is restored with physical therapy.What happens if you don't get bicep surgery? ›
Other arm muscles can compensate for the injured tendon, usually resulting in full motion and reasonable function. Left without surgical repair, however, the injured arm will have a 30 to 40% decrease in strength, mainly in twisting the forearm (supination).Is a repaired bicep tendon stronger? ›
Abstract. Background: Distal biceps tendon rupture is a common injury, and primary repair results in excellent return of function and strength.How painful is bicep repair surgery? ›
Swelling and pain is normal, especially for the first 48 hours. Each patient experiences discomfort to a different degree but you can expect your discomfort to decrease rapidly over the first 48-72 hours postoperatively. Ice can be applied as needed for 20 minutes at a time, with 20 minute breaks in-between.When is it too late to repair a torn bicep tendon? ›
Optimal timing for surgery is within the first 2 weeks of injury. Primary repair can be performed up until 6 weeks from injury. Beyond 6 weeks, patients will often need augmentation of the tendon with a graft (allograft) to extend the tendon in order to complete a repair.How long does it take for bicep tendon to reattach after surgery? ›
How long does it take to recover from biceps tendon surgery? The objective of torn biceps surgery is to reattach the tendon to the bone. Full recovery from biceps tendon surgery can be anywhere from six months to a year.Can you lift weights after bicep tendon surgery? ›
Light exercises can be reinstated shortly after surgery, but heavy lifting should be avoided for 3-4 months. A distal biceps tendon takes a little over three months to heal and regaining full strength and mobility will depend on the severity of the tear.How long does a bicep surgery take? ›
Surgery usually takes about 1 hour. The tendon is repaired through a small incision in the front of the elbow. Sometimes, a second incision in the back of the elbow may be needed. After surgery, a splint or brace is used to protect the repair for a short time while it heals.
You may be able to do easier daily activities in 2 to 3 weeks, as long as you don't use your affected arm. Most people who work at desk jobs can go back to work in 1 to 2 weeks. If you lift, push, or pull at work, you may be able to return in 3 to 4 months.How long do you wear brace after bicep surgery? ›
Your arm may be in a splint or an elbow brace for 4 to 6 weeks. You may also be in a sling for a week or so. You may feel tired and have some pain for several days. Your arm may be swollen, but the swelling should go down a little each day.
Most people can still function at a high level with a biceps tendon tear around the shoulder and only need simple treatments to relieve symptoms. You may benefit from surgery to repair the torn tendon if: Your symptoms cannot be relieved by nonsurgical treatments. You develop cramping in the muscle or pain.Can you live a normal life with a torn bicep? ›
The tendon itself can either tear partially or entirely. Most people will be able to continue living their lives without ever having to get surgery. A biceps tendon tear will cause you to lose some strength and mobility in your shoulder, but usually not enough to make a difference in your daily activities.Can you move your arm after bicep surgery? ›
Activity: You will have very little use of the operative arm for about six weeks after surgery until the tendon heals with the bone. Do not lift anything heavier than a pencil or pen until your sutures have been removed and you have been advised to advance your activity by your physician or therapist.How much strength do you lose with a torn bicep? ›
Patients lose approximately 25–30% of their supination strength. Flexion strength decreases acutely but improves to around only 15% loss after around 1 year from injury. In some patients the pain does not completely resolve. Once Range of motion restored question patients on all activities that are important to them.Is bicep tendon surgery serious? ›
There are risks to any surgery, and surgery for a biceps tendon tear is no different. Overall the risks are very low. The risks of a biceps tendon repair include infection, elbow stiffness, numbness in the forearm, and a potential injury to a nerve which can cause weakness in your wrist.How much is a torn bicep tendon worth? ›
The level of compensation you can expect for a torn bicep in a personal injury case will depend on the type and severity of the injury. The most serious types of bicep tears involve total tendon detachment and require reconstructive surgery. The typical settlement value of these cases is between $40,000 to $75,000.Will my bicep look normal after distal bicep surgery? ›
It will often look as though there is a tennis ball that is closer to the top of your arm than usual. This typically means the tendon has completely torn. In some cases, the tendon can tear partially, and the muscle contour may appear normal.How invasive is bicep tendon surgery? ›
Arthroscopic biceps tenodesis is a minimally invasive surgery to repair and reattach damaged biceps tendons. The biceps is probably the best-known muscle in the body.
While it is controversial, many surgeons will cut the biceps tendon if it has damage and then implant it into the top of the humerus or arm bone: a procedure called biceps tenodesis. The rationale is that cutting the biceps eliminates a potential pain generator after surgery.Does a torn bicep ever fully heal? ›
A complete bicep tear takes longer than a partial bicep tear to heal. Complete tears may require a bicep tendon surgery, after which it takes 6-9 months to recover completely.Does a torn bicep tendon hurt all the time? ›
Even if you don't experience sharp pain, a biceps tear often causes ongoing pain and tenderness in your shoulder or arm. The pain may get progressively worse the longer the tear is left untreated.Do you wear a cast after bicep tendon surgery? ›
If you underwent a surgery to reattach your biceps tendon at the elbow attachment, then you will be placed in a soft cast for 1 week after your surgery. This will limit the movement of your elbow as to not disrupt your biceps tendon repair. You will also be given a sling that you may wear for comfort.How do you sleep after bicep tendon surgery? ›
You may find that sleeping in a slightly upright position (ie reclining chair) with a pillow under your forearm will be your most comfortable position. Make sure to have your pain under control before you sleep.How can I speed up my bicep recovery? ›
- Sleep more. Sleep gives your muscles time to recover from exercise. ...
- Massage. Many athletes incorporate massage in their training to reduce muscle soreness. ...
- Compression garments. Wearing compression garments has become common among athletes over the past several decades. ...
- Contrast water therapy. ...
You may resume driving at approximately 2-3 weeks after surgery or when you have regained sufficient movements and control of the arm to drive safely. Return to work will depend on your occupation. Manual activities should be avoided for at least 3 months. Non-contact sports may be resumed at 4 months.What should I avoid after biceps tenodesis surgery? ›
No shoulder external rotation beyond 40 degrees. No shoulder extension or horizontal abduction past neutral. Place a towel roll or pillow under elbow while laying supine to avoid shoulder extension • No lifting objects. No friction massage to the proximal biceps/tenodesis site.Are you awake for bicep surgery? ›
Doctors usually perform surgical tendon repair under general anesthesia, so you are completely asleep during the procedure. The doctor makes small incisions in the skin over the tendon. If the tendon is torn, the doctor sews the ends together with small tools.What is the average recovery time for bicep tendon surgery? ›
It takes about 3 to 4 months for your biceps muscle to heal. You may be able to do easier daily activities in 2 to 3 weeks, as long as you don't use your injured arm. Most people who work at a desk job can return to work in 1 to 2 weeks.
One common complication after distal biceps tendon repair surgery is numbness and/or tingling on the thumb side of the forearm below the incision. There is a skin nerve that is very near the surgical field called the Lateral Antebrachial Cutaneous Nerve (LACN).