What is a Biceps Tenodesis?

Q: Are there important things I need to tell my doctors?

Redness, swelling or warmth around the cut . Leakage from the cut . Fever and chills. . Severe pain that is not relieved by prescribed painkillers. . Loss of control over arm movement . Loss of arm movement . Further surgery planned for the future i.e. dental work, bladder catheterisation, examinations of the bowel, bladder, rectum or stomach.

A biceps tenodesis is an operation that takes the tendon of the biceps muscle, removes it from where it usually attaches at the shoulder joint, and reattaches it on the arm bone (humerus).

A tendon is a thick band of fibres that attaches muscle to bone. The tendon of the biceps muscles can become irritated and inflamed near where it attaches at the shoulder joint. This is called biceps tendinitis. Treatment for this condition is usually conservative initially, with exercises and lifestyle modification. If these measures fail to improve the symptoms, surgery is considered. A Biceps tenodesis is one potential surgical option for this condition.

Who is this operation for?

This operation is for certain people who suffer from biceps tendinitis. Specifically, it is for people with this condition who have:

A significant tear in their biceps tendon
Anatomical variation in their arm bone that reduces stability of the tendon
Failure of other treatment/surgery

Complications

The risks and complications of a Biceps Tenodesis include:

Infection in the wound
A stiff shoulder or elbow
An ache at the front of the arm that keeps going
The tendon coming loose from where it was fixed. This sometimes needs another operation.
Numbness or tingling in the arm from nerve irritation
Pain that carries on, if the biceps tendon was not the only cause of the problem
Problems from the anaesthetic

For more information on the potential complications of any surgery, see Complications of Surgery.

Before the operation

Preadmission Clinic | Preparing for Surgery

Before your operation, you will be seen at the Preadmission clinic to make sure you are fit for the operation and all the necessary tests are performed in preparation for the operation.

During the visit, you will be seen by a

Doctor
Nurse
Anaesthetist (if necessary)

In some cases, a specialised assessment for anaesthesia is required.

Tests

Tests that may be ordered for you include:

shoulder X-ray
shoulder MRI
shoulder CT
shoulder USS
blood tests
X-ray of your Chest
Urine Test
ECG

Preparing Your Skin

Your skin should not have any infections or irritations before surgery. If either is present, contact your orthopaedic surgeon for a program to improve your skin before surgery.

Tip

Carry a list of your medications with you including the name, dosage and how often you take it.

Medications

Your treating team will advise you which medications you should stop or can continue taking before surgery.

About the Operation

A biceps tenodesis is usually a day operation. You go home the same day.

You will be asleep under a general anaesthetic. You may also have a nerve block. This is an injection that numbs the arm and keeps it comfortable for a while afterwards.

The biceps tendon is taken off the place where it attaches inside the shoulder joint. It is then fixed to the top of the arm bone instead. The surgeon holds it there with a small screw, an anchor or stitches.

The operation is often done at the same time as another shoulder repair. It usually takes less than an hour.

After the Operation

After the operation, you are cared for in the Theatre Recovery room. You will usually only spend 1–2 hours in the recovery room.

Most people wake up fully when back in their rooms on the ward. Whilst on the ward, the nurses will take care of your every need. It usually takes a few hours to recover fully from the anaesthetic, and the nurse will regularly check on your recovery.

Recovery and Rehabilitation

You will wear a sling for the first few weeks. This is mainly for comfort and to protect the repair.

First four to six weeks. Move your elbow and shoulder gently, as your physiotherapist shows you. Do not bend your elbow against weight. Do not lift with that arm.
Six to twelve weeks. The sling comes off. You start building strength with a physiotherapist.
After three months. You slowly go back to heavier activity. Heavy lifting and manual work usually wait until about four to six months.

An ache at the front of the arm is common for several months. This is normal.

Desk work is usually possible within a week or two. Manual work takes much longer.

F.A.Q.s | Frequently Asked Questions

What are the alternative treatments to having a Biceps Tenodesis?

Not everyone with a biceps tendon problem needs an operation. Other things to try first are:

Changing what you do, especially cutting back on lifting and reaching above your head
Physiotherapy to build up the muscles around the shoulder and shoulder blade
Simple pain relief and anti-inflammatory medicine
A steroid injection, which can settle the pain for a while

Some people choose not to have the tendon repaired at all. This is more common in older or less active people, because strength is often close to normal without the operation.

Are there important things I need to tell my doctors?

Redness, swelling or warmth around the cut
Leakage from the cut
Fever and chills.
Severe pain that is not relieved by prescribed painkillers.
Loss of control over arm movement
Loss of arm movement
Further surgery planned for the future i.e. dental work, bladder catheterisation, examinations of the bowel, bladder, rectum or stomach.