Biceps Tenodesis vs. Tenotomy
Tuesday March 14, 2006
Patients with biceps tendon problems, including biceps tendonitis and SLAP tears, may require surgical treatment. When the biceps tendon needs treatment, two options include biceps tenodesis and biceps tenotomy.
In a biceps tenodesis, the attachment of the biceps is moved to relieve pressure on the injured tendon. Patients have a slightly longer rehab, but better function and a normal appearing biceps muscle.
Patients who have a biceps tenotomy have the injured biceps tendon cut. The rehab is easy because there are no restrictions on the patient. There may be some arm cramping associated with a biceps tenotomy, and the biceps muscle may look slightly abnormal. Deciding which procedure is best for you depends on a number of factors you can discuss with your doctor.
Comments
The article says, “Deciding which procedure is best for you depends on a number of factors you can discuss with your doctor.” Can you please describe what these “factors” might be.
Factors include patient age, apprearance of the tendon at the time of surgery, other procedures being performed (for example rotator cuff repair), and surgeon preference. Many surgeons find that, in their hands, one procedure is far preferable to the other. Again, you should discuss with your doctor the plan for your surgery.
It seems highly unlikely full strength can be obtained after a biceps tenotomy.What are your thoughts on this?
Thank you
Any information on this procedure being performed on someone who had hemi-arthroplasty?
An MRI shows that I have a partial tear of the rotator cuff. Would a MRI with contrast tell if the biceps tendon is involoved?
My doctor did not discuss this procedure with me before hand. Initially I was to get a slap repair, but once in there he discovered it was a torn bicep tendon. My doctor did a Tenotomy on me and now I have cramping and weakness. Is there anything that can be done to fix this problem once this procedure has been done? I hate that this is the outcome.
To TJ – Did your doctor inform you that there was a possibility that you might need a tenotomy? If not, you have a potential claim. If you reside in NY, please contact me or David Blum at 212-947-9416 for a free consultation.
I have a slap tear and have the option of a tenodesis or tenotomy. My doctor likes to do tenodesis but told me of the additional risks of not working or infection. I am 45 and very athletic. What would you recommend?
I am 8 weeks post op for rotator cuff surgery and a tenomoty. I was NOT informed beforehand of the tenomoty. He explained the process of the rotator cuff surgery but made no mention other than saying he might have to “shave the bone” a bit. I am on worker’s comp as this resulted from a fall on the job due to negligence of another worker. I am also 50 years old, and used to manual labor as a way of making a living. I have been subsequently fired from this position. What are my rights here in the state of Georgia? On, and this surgery happened on my dominant side and until I asked my physical therapist this past week about the “bicep surgery” listed on my report, I didn’t even have an idea it had been done.
I am 3 months post op from a Hemi arthroplasy. More pain now than before. I can only manage pain with Celebrix and T3’s. One doctors possible diagnosis is bicep tendonitis. Some symptoms such as catching/pinching, are similar to ones prior to surgery. Could this problem have existed already and would not have been noticed during surgery. No MRI was done prior, only a CAT scan and X ray. If so, can this be treated? I am active 49 years old and am still not able to resume basic activities pain free.
I am scheduled for a biceps tenotomy and am not sure it is a good idea. I am only 38 years of age and am active in sports..especially volleyball. I get the feeling that this is a simple answer for the surgeon. Any inputs?
My husband is scheduled for surgery on Friday and says the doctor plans to sever his bicep tendon. This will be the 5th surgery on this shoulder. I am very concerned about the fact the it’s his dominant hand/arm (right). The physician states he may lose 20-30% of strength in that arm after procedure.
In technical terms, the long head of my Biceps tendon is subluxed off its humeral groove. My doctor has suggested either Tenotomy or Tenodesis, but seems to be pushing the tenotomy. I am 47 and very active in sports including some rock climbing. Everything I’ve read suggests some loss in strength, chance of cramping and possible “Popeye syndrome”. I’m inclined to get the tenodesis, and deal with the added rehab. Any suggestions form someone who has experienced this or from an MD?
I injured my shoulder at work in may of 2006,pain from chest/shoulder to elbow front to back.Went to Dr.he did surgery to release the bicep tendon,had surgery,still in pain,went back to Dr.he wanted to do surgery again,we went to 2nd Dr.,this Dr.repaired a tear in the rotar cuff.I am still having pain in the bicep from the 1st surgery,the arm is weak,cramps,and feels like stabing at chest/shoulder area.The 2nd Dr.suggested as a last resort to reattach the bicep tendon,may not make things any better.I going to see a 3rd Dr.soon and see what he says.Has any had this happen to them.
I had a surgery in sep 2006 doing a slap bank repair …. had bicep tendon pain but went back to work because of losing my job over it and retor my laberum and rotator cuff and had a second surgery in sep 2007 and that is working great besides the biceps tendon pain so now I have the same stupid option as everyone else as far as just clipping or replacing…. surgeon just thinks clipping it is the answer. I gotta think that cant be the best way.
I am in the military. I had a SLAP repair done in Dec. Afer physical therapy I was still in pain. So in May I had a Tenodesis performed. Now 6 weeks out my surgeon thinks the screw has seperated(waiting on MRI results). The doctor is 50/50 on going back in to reattach. I am 26 years old and extremly active. Any advice would be much appreciated.
I had a slap tear repaired on my right shoulder a few years ago. Two months after surgery, I still had the clicking sound & pain (tendon out of groove, passing over the bone) The doctor did a bicep tenodesis and after that I got a frozen shoulder. A year and a shoulder manipulation later eventually all felt well. Until this past month when I had pain in my right bicep, went back to Dr, had cortisone shot and one month of PT. Went back to Dr yesterday, he thinks I have a torn bicep tendon now, I will have an MRA soon. He also tells me if the bicep tendon is frayed and can’t be surgically repaired again, he will have to cut it. Leaving me with a “Popeye” bump on my bicep! (Very attractive I’m sure). I don’t want this and it will be my last resort. How will I know going in if it can’t be repaired or I end up with this lump on my otherwise normal arm? Am I being too vain, or is there another way to treat this(without cutting the bicep and losing 30% of the strength in my dominant right arm) even if the bicep
is frayed?
I have recently verified a partial thickness tear to my anterior rotator cuff..just saw my surgeon who explained to me that I may need a tenodesis vs. tenodomy….he says to seve the tendon is the easiest rehab..not sure but I agree with many others in the fact that I don’t feel I will be able to function as well without my bicep …any advice??
Had a tenodesis on 8-7-08 and still having severe pains all the way down my humorous and very limited motion due to pain 3 weeks after surgery. My advice…No surgery except as last resort and only if you can’t live with present pain level. Pain pump sucked too! That needle was stabbed into my neck in recovery while they were trying to discharge me! I thought that would have been done while still under anesthesia. Guess i was wrong! Only lasted about 8 hours and I woke up in middle of night crying like a baby girl !!! Pain resembled hot iron held to the bone for the first week. Still having severe “charlie horse” type pain in triceps and biceps muscles of left arm.
feel for you,had thermal shrinkage & decompression in 04, got severe frozen shoulder which spread to other shoulder, mua on that one,original shoulder been in pain ever since now they want to do tenodesis ,but i just cant face it ,i dont think it will work & think it will refreeze & iwill be in even more trouble.good luck all the best.
I had biceps tenodesis on non-dominant arm 5 weeks aago. Expected 2-4 weeks post op recovery time and scheduled work accordingly (I’m an Ob/Gyn). Still, though, I have minimal active motion capabilities and have had to cancel full month worth of surgeries. How long is this going to take to heal???
was doing fin 6 – 7 weeks post slap PT stretch me behing my back and ever since severe bideps pain and arm is amost non functional WC doc said I have adhesive capsulitis and wonts to wait on repeat MRI It has been 2 weeks with no relief even on new nasaid daypro any advise am so depressed
I had a tenodesis performed Nov., 5th, 2008. Almost 6 weeks post op and the pain at times is maddening. I am glad my surgeon was able to attach it. I know that it will take much longer to heal and to use my arm, but in the long run it will be worth the extra pain. Never let them do a tenotomy (cut and leave). If your Doctor did a tenotomy without your permission he was either incompetant or just lazy (maybe both), go after him.
You may lose 10% of your strength if you have a tenotomy, but you will probably lose 5% with a tenodesis. My advice, if you’re not a thrower, have the tenotomy. The result is much more predictable and there is usually a lot of pain relief associated with it. In fact, anyone getting a Hemi or TSR should have one of these procedures done at the same time.
I had a tenotomy and 90% rotator cuff repair on my dominant arm in September of 2007. My arm is still weak and sometimes cramps. Now there is a spot even with my elbow (inside left) that is extremely sore. Is this part of the tendon dying down? Does anyone have a similar issue? Anyone have a good reference on this procedure as to what percent permanent loss occurs? My doctor said 10% but I see others mention 30%. Thanks!
Shoulder Tenotomy Surgery for Mar 27, 2009. Fifty Two year old active female. Already weakened and limited by the injury (do not know when to quit). Can I expect enough strength to resume previous garden and gym activities?
I had my long head of the bicep released 5 months after I had slap repair. When the dr. went in the second time, he discovered that my bicep was “shredded” more than 50% and he decided to release it. Before surgery, there was no talk of releasing this, only talk of whatever he found, he would repair. I’m still experiencing 6-8/10 pain. Should I request that he go back and repair this instead of leaving it this way?
what is the usual timeline for healing of a bicep tendonesis? when will i be able to fire a weapon with the affected(dominant) hand at the range. i’m not asking my doc because he’s biased and seems to think i should be able to do a handspring 3 weeks post op. any opinions appreciated.
Surgery performed 03-27-09. Dominant Right Shoulder Rotator Cuff Repair, Acromioplasty (bone grinding), Biceps Tenotomy (Cut Tendon), ended up with a titanium screw! Almost two weeks. Still pain in shoulder and bicep tendon with tingling in arm. Work scheduled for 4-13-09 (2 weeks post-op), primarily at computer, desk type work. Arm is in pain and pulling, cannot find a position comfortable to work at computer…Any Tips? I am Female 52 years old, I have had surgery in the past; but never the “Ortho” type. If you can avoid this type of surgery…save yourself the pain!
Had left rotator cuff repair and tenotomy (without my knowledge) FEB 2007. Had right rotater cuff repair and tenodesis SEP 2008. Both are killing me. Am very wary about having anything else done but cannot stand the pain. Am a university tennis coach. Need guidance.
Ya all need to “suck it up”… surgery should always be used as a last resort, for pain relief and not necessarily to “return function”, and there is no guarentees that all pain will subside. Tenodesis and tenotomy are not complicated procedures and your bicep has a 2nd, more important tendon attatchment site than the one you are all talking about. Look it up in an anatomy book.
I am sucking it Up! Anatomy Book or not….Have you had your bicep tendon cut?
Hey Whiner, I am sucking it up! Surgery was a last resort. Have you ever had your bicep tendon cut……..please let us know….D
What are the chances of re-injury after a slap repair/ tenotomy, in sports or weightlifting for a reasonably active adult.