Biceps Tenodesis is a surgical procedure that is typically used to treat injuries to the biceps tendon in the shoulder. These injuries may occur due to an unstable or dislocating tendon, tendonitis, or tears in the tendon itself. The biceps is a major pain generator in the shoulder.
There are two main parts to the biceps tendon, the long head and the short head of the biceps. The long head is the portion that resides within the shoulder joint and is usually the one involved in shoulder issues. A tendon is the flexible cord of tissue that connects muscles to bones. Tendon problems may occur anywhere in the body, but are more common in certain joints including the shoulder because of its wide range of motion.
Candidates for Tenodesis
Patients may be considered for tenodesis surgery if they have been experiencing considerable pain and weakness in the shoulder due to a biceps tendon injury. This is often determined by a medical history, physical examination and imaging tests such as an X-ray or MRI scan of the joint. In addition, an arthroscopic evaluation of the joint may be necessary. A tenodesis procedure can be performed on patients of any age if they are experiencing biceps pain that has not responded to nonsurgical management.
The Tenodesis Procedure
Tenodesis is performed as an outpatient procedure that takes between 60 and 90 minutes to complete. After general anesthesia has been administered, the tenodesis procedure begins with the surgeon accessing the joint in the shoulder area. It is often performed arthroscopically, using a minimally invasive technique that involves making several small incisions into which a fiber-optic device and tiny surgical instruments are inserted, offering patients the benefits of less tissue damage and shorter recovery periods.
The surgeon removes damaged tissue around the biceps tendon and detaches the tendon from its connection with the labrum. Any bone or cartilage fragments or bone spurs found that may irritate the tendon will be removed. The tendon is then attached to the humerus bone near the shoulder joint using anchors and strong sutures to hold it in position. This serves to decrease the stress placed on both the tendon and the labrum.
Recovery from Tenodesis
No hospital stay is generally required following a tenodesis procedure. Patients will need to wear a sling for several weeks after the surgery to provide support and protection for the healing shoulder joint. Physical therapy aids the recovery process as it helps to strengthen and restore function to the shoulder. Most patients can return to work in sedentary jobs after a few days, but it usually takes three to six months before more strenuous activities may be permitted.
Risks of Tenodesis
Tenodesis is considered a safe procedure, however, all forms of surgery may carry some risk. The risks typically associated with tenodesis may include:
- Blood clot
- Damage to a nerve or blood vessel
- Biceps tendon tearing
In some cases, individuals may continue to experience pain, stiffness, muscle weakness and numbness in the affected arm and shoulder.