Open biceps tenodesis

Dr. Garcia demonstrates his technique for open biceps tenodesis

Biceps tenodesis is a surgical procedure used totreat of biceps tendonitis of the shoulder. The biceps tendon comes through the shoulder joint and attaches to the labrum. When this attachment is torn, it is a so-called SLAP tear of the shoulder. For further information on SLAP tear visit the SLAP tear section under Dr. Garcia’s patient education resources.

The three main causes of biceps pain are biceps irritation, a SLAP tear or an injury to the pulley that keeps the biceps in the groove of the shoulder

During a biceps tenodesis Dr. Garcia removes the attachment of the biceps tendon to the labrum and then reattaches it to the humerus bone. By performing a biceps tenodesis, the pressure is thereby removed from the labrum so there is no further pulling on the labrum or the tendon in the front of the shoulder.

What patients are most likely to have a biceps tenodesis?

This procedure is most often prescribed for those patients with significant biceps tendon symptoms as well as biceps tendon inflammation which is usually seen on arthroscopic surgeries including SLAP tears, rotator cuff repair or in isolation.

A biceps tenodesis procedure is most often performed in patients over 30-35 years old. More recent data is advocating for a biceps tenodesis over SLAP repairs for more reliable results, faster recovery and less stiffness. Other procedures, such as SLAP repair, may be performed in patients who are younger.

Other Indications for Biceps Tenodesis:

Other indication for treatment of the patients includes:

• severe biceps tendinopathy
• partial or full-thickness biceps tendon tears
• biceps instability associated with a rotator cuff tear.
• Acute proximal biceps ruptures

Biceps tenodesis involves detaching the long head of the biceps (there are two heads of the proximal biceps) from the superior labrum in the shoulder and reattached to the humerus bone just below the shoulder. The short head of the biceps is not moved and most of the strength of the biceps comes from this head. As such this procedure is used to improve cosmesis and reduce cramping but is less for strength gains.

The biceps tenodesis procedure is more complex than a tenotomy, but avoids the risks of biceps discomfort, weakness and a 'popeye' appearance.Tenodesis is preferable for more active people. Using modern fixation screws the repair is strong enough to move the arm early after surgery without weight

There are two surgical techniques for this open surgery. Either a supra or sub pectoraltenodesis. If sub pectoral, Dr. Garcia will perform this arthroscopically in most cases.

Following this surgery, your arm is placed in a shoulder sling for 4-6 weeks. Recovery can be up to 3-3.5 months. You will need physical therapy to regain motion and strength.

As with any procedure, biceps tenodesis may be accompanied by certain complications:

• Infection
• Bleeding
• failure of attachment
• stiffness.