Biceps tenotomy is an arthroscopic procedure to release the long head of the biceps tendon from its attachment inside the shoulder joint. It is performed for painful biceps tendon conditions and is a simpler alternative to tenodesis.
Performed arthroscopically through small incisions. The long head of the biceps tendon is identified at its attachment to the superior labrum and simply cut with arthroscopic scissors. The tendon retracts into the bicipital groove and scars in place. The operation takes 10–15 minutes and is often performed during other arthroscopic shoulder procedures.
Tenotomy is recommended for biceps tendinopathy, partial tears of the long head of biceps, and SLAP tears in patients over 55 or those with low physical demands. It is a quicker, simpler alternative to tenodesis.
Physiotherapy, corticosteroid injection, activity modification. Tenodesis is a surgical alternative that preserves biceps contour.
Usually performed during another arthroscopic procedure. Minimal additional preparation needed.
Reliable pain relief from the biceps source. Very simple procedure with minimal additional recovery time.
The biceps muscle may bunch in the upper arm when the tendon retracts. Occurs in approximately 30–40%.
Biceps cramping with heavy use.
The bulge may be noticeable.
Approximately 10–15% loss of elbow flexion and supination strength. Rarely clinically significant in older patients.
Some patients continue to have shoulder pain from other pathology.
General anaesthesia with nerve block (as part of the accompanying procedure).
Recovery is determined by the main procedure performed. Tenotomy itself adds minimal recovery time. Immediate elbow and forearm use is allowed.
As per the main procedure performed.
There is a small loss of supination and flexion strength, but this is rarely noticeable in daily life, particularly in patients over 55. Younger, active patients may prefer tenodesis to preserve strength.
Many patients do not notice it or are not concerned. If cosmetic appearance is important to you, tenodesis may be preferred.