Biceps Tenodesis

Biceps tenodesis is a surgery for biceps tendon injuries. The tendon connects the biceps muscle to the shoulder and elbow. This surgery aims to fix shoulder function and ease pain from tendon damage.

Biceps tendon injuries can happen from sudden trauma or long-term wear and tear. During the surgery, the damaged tendon part is removed. Then, the healthy tendon is attached to the upper arm bone.

This surgery makes the biceps tendon stable, helping it heal. After surgery, patients need time to recover. They also do physical therapy to get their shoulder strong and flexible again.

What is Biceps Tenodesis?

Biceps tenodesis is a orthopedic surgery that fixes biceps tendon injuries. The biceps muscle is in the upper arm and connects to the shoulder and elbow. Damage or inflammation here can lead to pain, weakness, and shoulder instability.

In this surgery, the surgeon removes the damaged tendon part near the shoulder. Then, they attach the healthy part to the upper arm bone (humerus). This aims to ease pain, improve strength, and enhance shoulder function.

This surgery is for those with chronic tendon inflammation, partial tears, or biceps tendon instability. It’s great for active people and athletes who do a lot of overhead activities or sports.

Compared to other treatments, biceps tenodesis has big benefits. It keeps the biceps muscle strong and looking good while fixing tendon problems. This reduces pain and discomfort.

After the surgery, patients often feel less shoulder pain, move better, and have more stable shoulders. With good care and rehab, most can get back to their usual activities and sports in a few months.

Anatomy of the Biceps Tendon

The biceps tendon is key to the shoulder and elbow’s function. It has two parts: the proximal biceps tendon at the shoulder and the distal biceps tendon at the elbow. Knowing about these tendons helps understand biceps tendon injuries.

Proximal Biceps Tendon

The proximal biceps tendon starts at the top of the shoulder blade (scapula). It goes through a groove in the upper arm bone (humerus) before attaching to the biceps muscle. This tendon helps keep the shoulder stable and aids in lifting the arm.

Injuries to this tendon often happen with other shoulder issues, like rotator cuff tears.

Distal Biceps Tendon

The distal biceps tendon connects the biceps muscle to the forearm bone (radius) near the elbow. It’s responsible for bending the elbow and rotating the forearm palm-up. Injuries here can lead to elbow pain and weakness in bending and rotating the forearm.

Distal biceps tendon ruptures are less common but can be severe if not treated.

Understanding the roles and locations of the proximal and distal biceps tendons aids in diagnosing and treating injuries. Proper care can improve strength and stability in the shoulder and elbow, easing pain and boosting function.

Causes of Biceps Tendon Injuries

Biceps tendon injuries can happen for many reasons. They can be caused by sudden trauma or by doing the same thing over and over. Knowing why these injuries happen is key to preventing them and treating them quickly. This is important because they often cause shoulder injury and elbow pain.

Acute Injuries

Acute injuries happen suddenly. They can be caused by lifting something heavy in a jerky motion, falling on an arm, or twisting the upper arm too much. These actions can tear the tendon, leading to pain and weakness right away.

Chronic Conditions

Chronic injuries develop slowly over time. They are often caused by doing the same thing over and over again. Biceps tendonitis, which is inflammation of the tendon, is a common condition. It can be caused by repetitive overhead movements, like in sports or certain jobs.

Other chronic conditions that can affect the biceps tendon include:

Risk Factors

There are several things that can make you more likely to get a biceps tendon injury:

• Age: The risk goes up as you get older because tendons degenerate
• Sports participation: Overhead sports like tennis, swimming, and baseball
• Occupations involving repetitive arm movements
• Smoking: Nicotine can impair tendon healing
• Corticosteroid injections: Repeated injections may weaken the tendon

By knowing the causes and risk factors of biceps tendon injuries, you can take steps to prevent them. If you have ongoing shoulder injury or elbow pain, see a doctor. They can give you a proper diagnosis and treatment plan.

Symptoms of Biceps Tendon Injuries

Biceps tendon injuries can cause a variety of symptoms. Pain in the front of the shoulder or elbow is common. This pain can feel like a dull ache or a sharp stab.

Swelling and tenderness in the affected area often accompany this pain. Weakness in the arm is another symptom. You might find it hard to lift objects or do tasks that need arm strength.

Cramping or spasms in the biceps muscle can also happen. These symptoms are more noticeable during activities that bend the elbow. Visible changes in the arm can indicate a biceps tendon injury.

In severe cases, a “Popeye” deformity may appear. This is when the biceps muscle bulges towards the shoulder. It looks like a lump.

If you notice any of these symptoms, seek medical help right away. A quick diagnosis and treatment can prevent further damage. Your doctor will do a physical exam and might order X-rays or MRI scans.

Diagnosis of Biceps Tendon Injuries

Getting a biceps tendon injury diagnosed right is key to treating it well. Orthopedic surgeons use both physical checks and imaging tests. They look at the damage’s extent and where it is, whether it’s in the shoulder injury or elbow pain.

Physical Examination

During a physical exam, the surgeon will:

• Check the affected arm for signs like bruising, swelling, or shape changes
• Feel the biceps muscle and tendon for tenderness
• Check how well the shoulder and elbow move and how strong they are
• Do special tests like Speed’s and Yergason’s to check the biceps tendon

Imaging Tests

Imaging tests give a closer look at soft tissues and bones. They help confirm the diagnosis and decide on treatment. Common tests include:

By mixing findings from physical exams and imaging tests, surgeons can accurately diagnose biceps tendon injuries. They then suggest the best treatment, which might be non-surgical or surgery like biceps tenodesis.

Treatment Options for Biceps Tendon Injuries

There are many ways to treat biceps tendon injuries. You can choose from non-surgical or surgical options. The right treatment depends on the injury’s severity, your age, how active you are, and your overall health.

Non-Surgical Treatments

For injuries that are not too severe, non-surgical treatments work well. These include:

• Rest and activity modification
• Ice therapy to reduce pain and inflammation
• Anti-inflammatory medications
• Physical therapy to improve strength and flexibility

These treatments help ease symptoms and aid in tendon healing. Often, a mix of rest, ice, and physical therapy helps people get back to their usual activities.

Surgical Treatments

For more serious injuries, surgery might be needed. The most common surgery is biceps tenodesis. It reattaches the torn tendon to the upper arm bone. This surgery is usually done through small incisions with special tools.

Another surgery, biceps tenotomy, releases the damaged tendon from its attachment. This can help with pain but might cause a bulge in the arm and some strength loss.

Choosing between tenodesis and tenotomy depends on several things. Your surgeon will consider your age, activity level, and how you feel about your appearance. They will help decide which surgery is best for you.

After surgery, taking care of your elbow and shoulder is key. Your surgeon will give you detailed instructions on how to care for your area. They will also guide you through the recovery process.

The Biceps Tenodesis Procedure

Biceps tenodesis is a surgery done by an orthopedic surgeon. It treats injuries or chronic conditions of the biceps tendon. The surgeon cuts the damaged tendon and attaches it to the upper arm bone (humerus). This restores the biceps muscle’s normal tension and function.

Preparation for Surgery

Before surgery, patients get a detailed check-up from their surgeon. This includes a physical exam, imaging tests, and a talk about their medical history and goals. They might be told to stop certain medications and fast for hours before the surgery.

Surgical Techniques

The surgery can be done open or arthroscopic, depending on the case and surgeon’s choice. An open surgery makes a small incision in the upper arm. Arthroscopic surgery uses small incisions and a camera and tools.

The surgeon cuts the damaged tendon and attaches the healthy part to the humerus with strong sutures or anchors. This secures the tendon and allows it to heal. The incisions are then closed with sutures or staples.

Postoperative Care

After surgery, patients wear a sling to protect their arm. They might use pain medication and ice packs for discomfort and swelling. They get specific instructions on caring for the site and gradually increasing activity.

Physical therapy is key in recovery. It helps restore range of motion, strength, and function to the arm. Most patients can get back to normal activities in several months. Full recovery can take up to a year.

Recovery and Rehabilitation after Biceps Tenodesis

After biceps tenodesis surgery, a detailed rehab plan is key for the best results. The recovery time can vary, but it usually starts with gentle exercises and moves to more intense ones.

In the first weeks, the focus is on letting the tendon heal. Patients might use a sling to keep their elbow stable. They also need to manage pain, take care of their wound, and do some gentle exercises.

Timeline for Recovery

Here’s a general idea of what to expect during recovery:

This timeline is just a guide. It can change based on the surgery, the patient, and the doctor’s plan.

Physical Therapy

Physical therapy is a big part of getting better after biceps tenodesis. A good physical therapist helps create a plan that focuses on moving better, getting stronger, and doing daily activities.

At first, therapy includes gentle range of motion exercises to keep the elbow and shoulder flexible. As healing happens, the therapist adds strengthening exercises to build muscle. These exercises target different muscles to help the patient get back to normal.

Later, therapy focuses on functional training and activities specific to the patient’s sports or hobbies. The therapist teaches the right way to do these activities to avoid injury.

Following the rehab plan and talking openly with the medical team is vital for a good recovery. With hard work and careful steps, patients can regain their strength and do what they love again.

Potential Complications and Risks

Biceps tenodesis is usually safe and works well. But, like any surgery, it can have risks. These include infection, nerve or blood vessel damage, stiffness, and the chance of getting hurt again. People getting elbow surgery or orthopedic surgery should talk about these risks with their doctor.

To lower the chance of problems, it’s key to follow all instructions before and after surgery. This might mean taking antibiotics, taking good care of the wound, and not overdoing it while you heal. Going to all your follow-up appointments and talking openly with your doctor can help catch and fix any issues early.

If complications happen, it’s important to act fast. Tell your doctor right away if you notice any signs of trouble, like more pain, redness, swelling, or discharge from the wound. With quick action and proper care, most problems can be fixed. This lets patients keep moving forward with their recovery after tendon repair.

Long-Term Outcomes and Patient Satisfaction

People who get biceps tenodesis for shoulder injuries often see great results. Studies show it cuts down pain and boosts arm function. Most can go back to their daily life and even sports after rehab.

High patient satisfaction shows the success of biceps tenodesis. Many feel their life quality improves a lot after surgery. They notice less pain and more strength and stability in their shoulder.

Several things can affect how well biceps tenodesis works. These include how bad the injury was, the patient’s age and health, and following the rehab plan. It’s key for patients to have clear expectations and work with their surgeon and physical therapist to get the best outcome.