The biceps muscle, located at the front of the upper arm, has two tendons that attach it to the bones of the shoulder: the long head and the short head. Biceps tenodesis is a surgical procedure used to address problems with the long head of the biceps tendon in the shoulder.
The most common type of biceps tendon injury is injury to the long head of the biceps tendon. It is a common source of shoulder pain and loss of strength that requires surgical intervention when nonsurgical treatment fails. Tears can also cause a deformity of the arm called Popeye deformity. This deformity is the result of a detached biceps tendon that allows the biceps muscle to bunch up on the upper arm.
- Repetitive overhead activities, such as those performed in certain sports (like swimming, baseball pitching, or tennis) or occupations (like painting or carpentry), can lead to overuse injuries. These repetitive motions can cause wear and tear on the tendon over time.
- Acute trauma from a sudden, forceful movement such as lifting a heavy object improperly.
- Shoulder impingement – A condition that narrows the space through which the biceps tendon passes can lead to impingement, where the tendon rubs against bone, causing irritation and inflammation.
- Joint instability such as a shoulder dislocation
- Degenerated biceps tendons
- Rotator cuff tears that alter normal shoulder dynamics
- SLAP tears- A tear of the superior labrum from anterior to posterior (SLAP) can involve the biceps tendon anchor, which can cause or exacerbate issues with the long head of the biceps.
A biceps tenodesis involves detaching the long head of the biceps tendon from its original attachment in the shoulder socket (the glenoid labrum) and reattaching it to the humerus (upper arm bone). Tenodesis is often combined with other necessary surgical procedures such as rotator cuff tear repairs. Complications are rare.
It is indicated when:
- When there is chronic biceps tendonitis – a persistent inflammation of the tendon, often due to overuse, which leads to pain and discomfort.
- When the tendon is partially torn and does not heal properly with nonsurgical treatments.
- When there is a SLAP (Superior Labrum Anterior and Posterior) tear- a tear of the shoulder labrum, the cartilage lining the shoulder socket, where the biceps tendon is attached.
- When there is ongoing shoulder instability or pain that is linked to the biceps tendon, tenodesis might be considered. This may be from chronic instability where the shoulder dislocated frequently or feels as though it might. Tenodesis can stabilize the join.
In these situations, biceps tenodesis can be an effective way to alleviate pain, improve shoulder function, and prevent further damage to the tendon.
It may be performed as open surgery or arthroscopic minimally invasive surgery. The surgeon detaches the long head of the biceps tendon from its original attachment at the superior labrum.
The new site on the humerus (upper arm bone) is prepared to receive the tendon. This often involves creating a small hole or trough in the bone. The tendon is then reattached to the humerus using a variety of methods. It can be secured with suture anchors, screws, or other fixation devices that hold the tendon in place against the bone. The incisions are closed with sutures or staples.
After surgery the arm may be placed in a sling or other immobilization device to keep it stable and allow the tendon to heal in its new location. The specific techniques used can vary based on the surgeon’s preference, the patient’s anatomy, and the specifics of the tendon injury. After the procedure, a structured rehabilitation program is essential to regain full function of the arm and shoulder.
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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.