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Biceps Tenodesis

What is biceps tenodesis?

Biceps tenodesis is a type of surgery used to treat shoulder pain or problems caused by tissue damage. The biceps muscle has two tendons near the shoulder, and it’s the long head that is often implicated in shoulder issues. Tears of the biceps tendon are common in athletes.

Biceps tenodesis may be indicated when there is biceps tendonitis, shoulder instability or a SLAP tear. A SLAP tear is an injury to the labrum of the shoulder, which is the ring of cartilage that surrounds the socket of the shoulder joint. SLAP tears often involve the biceps tendon, which attaches to the labrum. In cases where the biceps tendon is involved or when the tear is causing bicep-related symptoms, a biceps tenodesis might be performed.

The main objectives of this surgery are to alleviate shoulder pain that results from inflammation and tendon deterioration caused by injury, excessive use, or the natural aging process, and to restore function.

Biceps tenodesis is a minimally invasive arthroscopic procedure requiring only a few small incisions on the front of the shoulder. The arthroscope itself is a small, tube-shaped instrument that has a light source and a video camera on its end. The camera on the arthroscope sends images to a video monitor, giving Dr. Petrigliano a clear and magnified view of the structures within the joint. This allows him to inspect the joint for damage, determine the cause of a patient’s symptoms, and perform the biceps tenodesis. The procedure involves detaching the long head of the biceps tendon from the labrum, removing the damaged section and reattaching the tendon to the upper arm bone with sutures or screws.

After surgery, you will wear a sling for the about 2-4 weeks to protect the shoulder as it heals. It is likely that you will begin gentle range of motions exercises guided by a physical therapist. After this initial recovery period, more intensive physical therapy often begins. This therapy is designed to restore strength and flexibility to your shoulder and arm. This can last several weeks to a few months.

Full recovery, meaning a return to all normal activities including sports and heavy lifting, typically takes about 4 to 6 months, but it can sometimes take longer. These are general guidelines. Individual experiences can vary significantly.

Studies suggest that biceps tenodesis has a high success rate. Most patients experience significant pain relief and return to their prior level of function. Some studies have reported success rates (defined by patient satisfaction and/or return to prior level of function) of around 90% or higher. 

Los Angeles shoulder surgeon, Dr. Frank Petrigliano is an internationally regarded expert on shoulder injuries, conditions and treatments. Whether you are young or old, athlete or not, suffering from shoulder pain or an injury can be disabling. Contact Dr. Petrigliano at UCLA. He can help.


References

  1. Kreulen RT, Agarwal AR, et al. SLAP repair and bicep tenodesis: a comparison of utilization and revision rates for SLAP tears. JSES Int. 2022 Dec 10;7(2):290-295. doi: 10.1016/j.jseint.2022.11.001. PMID: 36911775; PMCID: PMC9998736.
  2. Lorentz NA, Hurley ET, et al. Return to Play After Biceps Tenodesis for Isolated SLAP Tears in Overhead Athletes. Am J Sports Med. 2022 Apr;50(5):1369-1374. doi: 10.1177/03635465211041698. Epub 2022 Mar 28. PMID: 35341336.
At a Glance

Dr. Frank Petrigliano

  • Vice Chair of Education for the UCLA Department of Orthopadic Surgery
  • Head team physician for the LA Chargers Football
  • Associate team physician for UCLA Athletics
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