Biceps Tenodesis & Tenotomy: Relieving Shoulder Pain and Restoring Function

The biceps tendon, which connects the biceps muscle to the shoulder joint, can often be a source of pain and discomfort for many individuals. Two common surgical procedures used to address biceps-related shoulder issues are biceps tenodesis and biceps tenotomy. These techniques aim to alleviate pain, restore shoulder function, and improve overall quality of life for those suffering from biceps-related conditions.

Biceps tenodesis involves surgically reattaching the biceps tendon to a different location within the shoulder, while biceps tenotomy involves cutting the tendon and allowing it to retract into the upper arm. Both procedures are designed to address various shoulder problems, including biceps tendinitis, SLAP (superior labrum anterior to posterior) tears, and other degenerative conditions affecting the biceps tendon.

When is Biceps Tenodesis or Tenotomy Recommended?

Biceps tenodesis and tenotomy are typically recommended when conservative treatment options, such as physical therapy, anti-inflammatory medication, and cortisone injections, have failed to provide sufficient relief. These surgical interventions may be considered in the following scenarios:

1. Biceps Tendinitis: Chronic inflammation and pain in the biceps tendon that does not respond to non-surgical treatments.
2. SLAP Tears: Tears in the superior labrum, the cartilage lining the shoulder socket, which can cause biceps-related pain and instability.
3. Biceps Instability: Conditions where the biceps tendon is unstable or dislocating within the shoulder joint.
4. Rotator Cuff Tears: Tears in the rotator cuff muscles, which can lead to secondary biceps tendon problems.
5. Biceps Degeneration: Wear and tear of the biceps tendon, often associated with aging or overuse.

Benefits of Biceps Tenodesis and Tenotomy

Both biceps tenodesis and tenotomy offer several potential benefits for individuals suffering from biceps-related shoulder issues:

1. Pain Relief: These procedures aim to eliminate the source of pain by addressing the underlying biceps tendon problem.
2. Improved Shoulder Function: By addressing the biceps tendon issue, patients often experience enhanced shoulder mobility, strength, and overall function.
3. Reduced Risk of Future Complications: Addressing the biceps tendon can prevent further damage or complications, such as tendon rupture or continued instability.
4. Faster Recovery: Compared to more complex shoulder surgeries, biceps tenodesis and tenotomy generally have a shorter recovery time and allow for a quicker return to daily activities and sports.

The Procedure: Biceps Tenodesis vs. Tenotomy

Biceps Tenodesis:

• During this procedure, the biceps tendon is surgically reattached to a different location within the shoulder, such as the upper arm bone (humerus).
• This helps to maintain the length and function of the biceps muscle, while eliminating the source of pain or instability.
• Biceps tenodesis is often preferred for younger, more active patients who wish to preserve biceps muscle function.

Biceps Tenotomy:

• In this procedure, the biceps tendon is surgically cut, allowing it to retract into the upper arm.
• This effectively removes the source of pain or instability, but it can result in some loss of biceps muscle strength and function.
• Biceps tenotomy is often preferred for older patients, those with limited shoulder function, or individuals who are less active and do not require maximum biceps strength.

Recovery and Rehabilitation after Biceps Tenodesis or Tenotomy

Regardless of the specific procedure, patients can expect a similar recovery and rehabilitation process:

1. Immediate Postoperative Period: Patients will typically wear a sling or immobilizer for the first 4-6 weeks to protect the surgical site and allow for initial healing.
2. Early Rehabilitation: Once the initial healing phase is complete, patients will begin a structured physical therapy program to regain range of motion and gradually restore shoulder strength and function.
3. Long-Term Rehabilitation: The full recovery process can take several months, with patients typically able to return to most daily activities and light sports within 3-6 months. More strenuous activities and sports may require a longer rehabilitation period.

Throughout the recovery process, patients will work closely with their orthopedic surgeon and physical therapist to ensure a safe and effective rehabilitation plan tailored to their individual needs and goals.

Conclusion: Living Pain-Free with Biceps Tenodesis or Tenotomy

Biceps tenodesis and tenotomy are effective surgical interventions that can provide lasting relief from shoulder pain and restore function for individuals suffering from various biceps-related conditions. By understanding the benefits, the surgical procedures, and the rehabilitation process, patients can make an informed decision about the best treatment option for their specific needs.

If you are experiencing persistent shoulder pain or discomfort related to your biceps tendon, we encourage you to schedule a consultation with our experienced orthopedic team. Our specialists will thoroughly evaluate your condition and work with you to develop a personalized treatment plan, which may include biceps tenodesis, tenotomy, or other conservative and surgical options. Take the first step towards living a pain-free, active lifestyle by contacting us today.