Biceps Tenodesis
What Is Biceps Tenodesis?
Biceps tenodesis is a surgical procedure that treats a damaged long head of the biceps tendon by detaching it from its original attachment point inside the shoulder joint and reattaching it to a new location on the humerus, just outside the joint. This relieves pain generated by the damaged portion of the tendon while still preserving the biceps muscle’s overall function and appearance.
When Is Biceps Tenodesis Needed?
Biceps tenodesis may be recommended for:
- Chronic biceps tendonitis that hasn’t improved with a thorough course of nonsurgical treatment
- A partial tear of the biceps tendon at its attachment inside the shoulder
- Certain SLAP tears (labral tears at the top of the socket where the biceps tendon attaches), particularly in older or less overhead-active patients
- Biceps-related pain occurring alongside another shoulder procedure, such as a rotator cuff repair, where addressing the biceps at the same time can improve overall outcomes
How Is Biceps Tenodesis Performed?
The procedure is typically performed arthroscopically, sometimes combined with a small additional incision to complete the tendon transfer. The damaged portion of the biceps tendon is released from its attachment point inside the joint, near the top of the socket. The remaining healthy tendon is then repositioned and securely reattached to the humerus, just below the shoulder joint, using an anchor or screw device. This relocates the point of tension away from the irritated area inside the joint to a new, more stable attachment point on the bone.
Biceps Tenodesis vs. Biceps Tenotomy
A related, simpler procedure — a tenotomy — simply releases the damaged tendon without reattaching it elsewhere, allowing it to retract. While a tenotomy involves a shorter recovery, it can result in a visible cosmetic change (sometimes called a “Popeye deformity,” where the biceps muscle bunches up) and a small amount of biceps strength reduction, particularly noticeable in younger or more muscular patients. Tenodesis avoids this cosmetic change by reattaching the tendon at a new location, which is why it’s often preferred for younger, more active, or more cosmetically concerned patients, even though it requires a somewhat longer recovery than a simple tenotomy.
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Recovery After Biceps Tenodesis
- A sling is typically worn for a few weeks to protect the new tendon attachment
- Early restrictions usually limit heavy lifting and resisted elbow bending, since these motions place direct stress on the healing tenodesis
- Physical therapy progresses gradually over the following weeks to months
- Return to full activity, including heavier lifting, generally takes around 3 to 4 months, allowing the tendon time to firmly heal into its new position
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Dr. Palsis specializes in the treatment of knee, shoulder, and sports injuries.