How is a biceps tendon tear in the shoulder repaired?
The biceps tendon connects the biceps muscle on the front of the arm to the shoulder and often is subject to excessive strain that may result in a biceps tendon injury. If the biceps tendon is torn, and other treatments such as oral anti-inflammatory medication, injections, and physical therapy are not effective, the biceps tendon cannot heal by itself and may require surgical treatment with a biceps tenodesis procedure. This surgery repairs the torn biceps tendon by removing injured tissue and reconnecting the healthy tendon tissue to the humerus in the upper arm. Dr. Joseph Lamplot, orthopedic shoulder surgeon, treats patients in Arlington Heights, Kildeer, Lake Zurich, Barrington, and the surrounding Northwest Suburbs of Chicago, IL, who have torn their biceps tendon and need a biceps tenodesis.
How is a biceps tenodesis done?
Biceps tenodesis is either an arthroscopic or mini-open procedure where a small surgical camera (arthroscope) and other specialized surgical tools are inserted into small incisions in the upper arm to perform the surgery. Dr. Lamplot will use these tools to first remove any damaged tissue. He will then release the biceps tendon from its original attachment site in the shoulder. This portion of the biceps tenodesis is known as a tenotomy. Dr. Lamplot will then reconnect the biceps tendon to the humerus in the upper arm using strong specialized surgical sutures and either a button or anchor.
Do I need my torn biceps repaired?
Not all biceps tears must be repaired. It is recommended that this type of injury is repaired if a patient experiences a proximal tear (near the shoulder) and fails to improve with non-surgical treatments such as oral anti-inflammatory medication, physical therapy, or injections. Additionally, a complete upper biceps tear can result in a physical deformity known as a “pop-eye muscle” in which the biceps muscle balls up within the lower part of the upper arm just above the elbow. It is important to note that if a patient experiences a distal biceps tendon tear (near the elbow), a surgical repair should occur within one month of injury. Dr. Lamplot will provide recommendations and help to decide the best treatment option for each patient.
Why does my doctor want to wait to repair my biceps tendon?
If you are responding well to nonsurgical treatments, your doctor may not recommend biceps tenodesis to repair the tendon. Additionally, if there are other injuries to the patient’s shoulder such as a rotator cuff tear undergoing repair, your doctor will likely treat both during the same surgery. This recommendation will vary based on the patient’s activity level, occupation, age, preexisting shoulder injuries, and other factors. Dr. Lamplot will evaluate all of these factors plus more in order to determine the best treatment plan for the patient, including the possibility of waiting to repair the biceps tendon.
How long is the recovery after a simple biceps tenodesis?
Simple biceps tenodesis (without rotator cuff repair):
- Immediately following the surgery, the patient will be required to wear an arm sling for approximately 6 weeks. The patient will participate in physical therapy to build strength, flexibility, and range of motion in the upper arm and shoulder. A patient can expect to have a full range of motion and the ability to perform everyday tasks approximately 3 months after surgery. Full recovery including the return to sporting activities can be expected after approximately 6 months.
Biceps tenodesis with rotator cuff repair:
- This type of surgery is more complicated as more components of the shoulder will have been repaired during the procedure. Physical therapy will also be required following this type of procedure. However, recovery from this more involved procedure is quite similar, with most patients returning to all activities within approximately 6 months of surgery.
