Biceps tenodesis

Overview

Biceps tendon tears brought on by trauma or overuse are treated surgically with biceps tenodesis. SLAP tears, or tears in the labrum (the cartilage lining the interior of the shoulder joint) are also treated by this treatment.

The biceps tendons connect the upper arm’s biceps muscle to the shoulder at one end and the elbow at the other. The biceps tendon separates into the long head and the short head at the shoulder end.

The biceps tendon is separated from the labrum and moved to the upper arm bone (humerus) during biceps tenodesis.

Reasons for undergoing the procedure

A significant number of individuals with a torn biceps tendon can continue to maintain their normal level of functioning. Simply applying ice, taking aspirin or ibuprofen and getting some rest may be all that’s required. Physical therapy and cortisone injections may also be helpful.

Surgery can be required if these options are ineffective or if the patient needs to fully recover their strength. To help assess the severity of the patient’s injury, the healthcare provider may examine the arm and shoulder in a number of ways.

The tendons or fibrocartilage that hold the upper arm into the shoulder are repaired during these treatments. Biceps tenodesis is frequently performed in conjunction with other shoulder procedures, which may encompass addressing issues such as a labral tear (SLAP) or undergoing rotator cuff surgery.

Risk

The following increase risk factors for biceps tears include:

• Age: Wear and tear can elevate the chances of a tear occurring.
• Overuse: Sports like swimming, tennis, and baseball that require frequent overhead arm movements can make the biceps tendon more vulnerable to injury. Similar results could be obtained from several physical tasks.
• Corticosteroids: These medications, which are prescribed for many kinds of conditions including joint pain, have been related to an increased risk of biceps tears.
• Smoking: Nicotine can weaken a tendon by decreasing the proper delivery of nutrients to it.

Procedure

Biceps tenodesis is a surgical procedure designed to alleviate pain and weakness in the shoulder and biceps muscles resulting from a tear in the long head of the biceps tendon. This specific tendon is situated at the upper part of the bicep muscle and is attached to the labrum, which is cartilage that lines the shoulder socket.

The biceps tendon is released from the labrum during the biceps tenodesis surgery by the healthcare provider. In certain cases, the surgeon repositions the biceps tendon to the upper arm bone, known as the humerus.

A healthcare provider has the option to repair the biceps tendon through either open surgery or arthroscopic surgery.

Before the procedure

Before the procedure, the patient will be administered either general anesthesia or regional anesthesia. The healthcare provider will give more detailed recommendations, but in general, patient should follow the following guidelines:

• Patients should fast for eight hours before visiting a hospital. (Sip some water while taking the prescribed medication, such as blood pressure medicine.)
• Refrain from taking Viagra or similar medications for erectile dysfunction for a minimum of 24 hours prior to the surgery.
• If the patient is a smoker, it is advisable to stop smoking for a period of two weeks leading up to the surgery. Quitting smoking can enhance heart and lung function, which is beneficial during the surgical procedure.
• Discontinue the use of herbal supplements for one to two weeks prior to the surgery.

During the procedure

• The surgeon makes a cut near the point where the top of the biceps tendon attaches to the labrum.
• Surgeon release the biceps tendon from the labrum by pulling it through the incision.
• A small hole is being drilled in the upper arm bone.
• The bicep tendon is pushed into the hole in the upper arm bone by using a suture anchor. This is known as the screw fixation technique.
• After the procedure, the surgeon closes the incision.

After the procedure

• The patient may be given a painkiller that may cause their shoulder to remain numb for several hours following surgery.
• Following the procedure, they will need to wear an arm sling for four to six weeks. As a result, individuals might have to request assistance with daily tasks like driving or take time off of work.
• The patient will undergo physical therapy, which will start around two weeks following the procedure and last for many months.

Outcome

Biceps toneless recovery takes a lot of time. Rest, sling use, and physical therapy are required. By four to six months following surgery, the majority of patients have a useful range of motion and enough strength. Up to a year may pass before they fully recover.

Physical therapy normally progresses with the following phases:

1. Passive range of motion exercises begins in the initial one to two weeks following the operation.
2. Active range of motion exercises typically begin around the fourth week.
3. The strengthening phase start approximately six to eight weeks post-operation.
4. The advanced strengthening phase usually starts around the tenth week, and it’s important to note that heavy lifting should be avoided prior to this phase.

Engaging in physical activities, whether they involve exercise, sports, or weightlifting too soon after biceps tenodesis surgery can hinder the recovery. It’s important to consult with the healthcare provider about adding specific activities into the physical therapy regimen.

Any unexpected pain or other symptoms should be reported right once to the healthcare provider and physical therapist.

Seek medical attention if the patient is experiencing the following:

• Heavy bleeding and still continue even after applying pressure to the area.
• Persistent pain that doesn’t relieve even with pain medication.
• Swollen arm.
• Fever with temperature of 101 F (38.3 C) and higher.
• Tingling or numbness in the hands or fingers.
• Darkening of the hand or fingers.
• Any redness, discomfort, swelling, or yellowish discharge from the surgical site.