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Elbow & Wrist

Biceps Tendon Repair / Reconstruction

The biceps muscle, located at the front of the upper arm, plays a pivotal role in the movement of the forearm, particularly in rotation and flexion. This muscle has two tendons that attach it to the bones in the shoulder and one tendon that attaches it to the radius bone at the elbow. A biceps tear can involve either the proximal biceps tendon at the shoulder or the distal biceps tendon at the elbow.

  • Proximal biceps tendon tears are more common and typically involve the long head of the biceps. They can be complete or partial. Complete tears fully detach the tendon from the bone, while partial tears damage the soft tissue but do not completely sever the tendon from the bone.
  • Distal biceps tendon tears are less common than proximal tears. These occur when the tendon attaching the biceps muscle to the forearm bone (radius) is torn. These are usually complete tears and more likely to require surgical intervention. Distal biceps tendon tears typically occur in athletes, especially in weight lifting and contact sports such as football. They often affect active middle-aged men in their dominant arm.

  • Proximal biceps tendon repair is less common than distal repairs, as many proximal biceps tendon tears are treated nonsurgically. When surgery is required, it typically involves re-attaching the torn tendon to the humerus bone in the shoulder. Sometimes, the surgeon may opt for a procedure called biceps tenodesis, where the tendon is attached to a different location, often due to the tendon being too frayed or degenerated for a standard repair. It may be performed as open surgery or minimally invasive surgery.
  • Distal biceps tendon repair is a more common surgical procedure because distal tears often result in significant loss of strength and function, particularly in forearm rotation and elbow flexion. The surgery involves re-attaching the tendon to its original attachment point on the radius bone at the elbow. This is usually done through an incision in the front of the elbow, and the tendon is re-attached using suture anchors or other fixation devices. It may be performed as open surgery or minimally invasive surgery.

  • For complete tears where the tendon is torn off the bone
  • For partial tears with significant symptoms that cause pain, weakness and functional impairment
  • For active individuals, especially those who are involved with heavy lifting, athletic activities who choose surgery to regain full strength and function.

Tendon reconstruction is a surgical procedure aimed at restoring the function and strength of a tendon that has been severely damaged or degenerated. This approach is often used when the tendon cannot be simply reattached to the bone due to the extent of the injury or the quality of the tendon tissue. It is also indicated when the tear is chronic and has caused the tendon to shorten or scar, making repair impossible. Tendon reconstruction is different from primary tendon repair, which involves directly reattaching a torn tendon.

Tendon reconstruction involves the use of a graft to replace or augment the damaged tendon. It can be taken from another part of the patient’s body (an autograft) or from a donor (an allograft), and in some cases a synthetic graft can be used.

The graft must be harvested from the patient’s body, usually a hamstring tendon is used. The damaged or scarred tissue is removed, and the bone is prepared for the graft. The graft is anchored to the bone using suture anchored or other fixation devices to ensure it replicates the function of the original tendon.

Initially the joint is immobilized to protect the reconstruction.  Gradual rehabilitation is vital to regain range of motion, strength and function. Sport specific training will be included for athletes.

Recovery from a primary tendon repair is often quicker than reconstruction. Athletes may begin returning to sports activities in 4-6 months, but this can vary. Recovery from reconstruction can take longer, often taking 6-12 months or more, depending on the complexity of the surgery and the type of graft used.

The time required to return to sports after a tendon repair or reconstruction varies depending on several factors, including the type of procedure, the specific tendon involved, the athlete’s overall health, the nature of the sport, and the level of play. Generally, the recovery period can range from several months to a year or more.

Schedule a orthopaedic consultation

At Silicon Valley Orthopedics we treat athletes and non-athletes alike with cutting-edge techniques and procedures as well as nonsurgical options that will help healing when time and patience are in order. Contact us to schedule a consultation to learn all your treatment options. We have offices in Fremont, Los Gatos and Menlo Park. At Silicon Valley Orthopedics we strive for compassionate, personalized care and treatment options geared to your needs.