Biceps Tenodesis

Biceps tenodesis is a surgical procedure that involves reattaching the top end of the biceps tendon to a new location. This procedure may be needed when the biceps tendon is severely degenerated, torn, or identified as a cause of pain in the shoulder.

Many techniques have been developed to perform a bicep tenodesis.  It is most often performed as an adjunct to arthroscopic surgery for rotator cuff disease.  

Minimally Invasive Biceps Surgery

Biceps tenodesis is usually performed arthroscopically and may be combined with acromioplasty, another surgical procedure often used to treat biceps tendonitis. Arthroscopy is a minimally-invasive procedure allows your doctor to assess the condition of the biceps tendon as well as other structures in the shoulder. The advantage of using the arthroscope is that less normal tissue is damaged. This may result in faster healing and recovery.

Open Biceps Surgery

The procedure can also be performed using the open method.  The surgeon begins by making an incision on the front of the shoulder, just above the axilla (armpit). The overlying muscles are separated so the surgeon can locate the top of the biceps tendon. The end of the biceps tendon is removed from its attachment at the top of the glenoid. The tendon is prepared by cutting away frayed and degenerated tissue.

There are multiple techniques to firmly fix the detached bicep tendon to the front surface of the humerus.  Surgeons have the option of using small suture anchors, screws, or keyholes drilled in the humerus to ensure that the bicep in adequately tensioned for normal function.

Rehabilitation after Biceps Tenodesis Surgery

After surgery, you will meet with a SROSM physical therapist who will design a rehabilitation for you. Exercises start slow and gradually get more challenging over time, focusing on improving movement in the forearm, elbow, and shoulder.

Heavier exercises for the biceps muscle are avoided for two to four weeks after surgery. Your therapist may begin with light isometric strengthening exercises. These exercises work the biceps muscle without straining the healing tendon.

You may require physical therapy for six to eight weeks. It generally takes three to four months, however, to safely begin doing forceful biceps activity after surgery.

To speak with an SROSM shoulder specialist, make an appointment at the location closest to you in Spring or The Woodlands. You can also learn more about biceps tendonitis by downloading our educational document A Patient’s Guide to Biceps Tendonitis.