Biceps Surgery - Tenodesis vs Tenotomy

The long head of the biceps runs along the bicipital groove, enters the shoulder joint, and attaches to the superior labrum. In SLAP tears, the biceps tendon can be involved in varying degrees, ranging from mild fraying and inflammation to detachment along with the labrum. The portion of the biceps tendon running along the bicipital groove can also be inflamed, frayed, or damaged in isolation (without SLAP tear) and become a source of shoulder pain.

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Biceps tenotomy and tenodesis are surgical procedures aimed at addressing issues with the biceps tendon, particularly in cases of SLAP tears or isolated damage. Each procedure offers unique benefits and considerations, depending on the patient's age, activity level, and the extent of tendon involvement.

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Biceps Tenotomy:

Biceps tenotomy involves the surgical release of the biceps tendon from its attachment to the superior labrum. This procedure effectively relieves tension on the tendon and alleviates associated pain. By detaching the tendon from the labrum, biceps tenotomy eliminates the source of discomfort without the need for reattachment.

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Biceps Tenodesis:

In contrast, biceps tenodesis involves the reattachment of the biceps tendon after its release from the superior labrum. However, instead of reattaching the tendon at its original site, it is secured lower down on the humerus (arm bone). This technique aims to maintain the functional integrity of the biceps muscle while addressing underlying pathology.

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Choosing the Right Option:

Both biceps tenotomy and tenodesis are reliable surgical options for addressing biceps tendon pathology and relieving shoulder pain. The decision between the two procedures depends on various factors, including the patient's age, activity levels, and the condition of the tendon. Your surgeon will carefully evaluate your specific case and recommend the most suitable option to achieve optimal outcomes.

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Considerations and Recovery:

Following either procedure, patients can expect a period of postoperative rehabilitation aimed at restoring shoulder function and strength. Physical therapy plays a crucial role in this process, guiding patients through exercises to promote healing and improve range of motion. While recovery times may vary, both biceps tenotomy and tenodesis offer promising outcomes for relieving pain and enhancing shoulder function.

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