Proximal biceps tenodesis is the surgical reattachment of a torn proximal biceps tendon, which connects the upper part of your biceps muscle to the shoulder.
Causes for a proximal biceps tendon tear may include:
- Lifting very heavy objects
- Falling on an outstretched arm
- Excessive use of the shoulder during sports activities Symptoms
Symptoms of biceps rupture include one or more of the following symptoms:
- Sudden, sharp shoulder or upper arm pain
- Snapping sound or pop in the shoulder or upper arm region
- Tenderness at the shoulder
- Biceps muscle cramping
- The weakness with shoulder and elbow movements
- Difficulty rotating the forearm
Diagnosis
The physician will perform a detailed physical examination looking for specific signs will such as where the biceps muscle bunches up near the elbow which implies a complete rupture of the proximal tendon. With partial ruptures, you feel pain while bending the arm. To confirm the diagnosis an MRI or CT scan may be recommended and ordered.
Treatment
Conservative treatment may include:
- Medication
- Resting or avoiding activities that aggravate your symptoms
- Application of cold packs
- Physical therapy
Surgery
Proximal biceps tenodesis is recommended if nonsurgical treatment methods are insufficient or other structures are found to be injured in the shoulder. Additionally, surgery may be recommended for active individuals who requires restoration of muscle strength.
If surgery is indicated, your doctor will give you specific instructions on how to prepare for the procedure. This may include avoiding some medications a few days before the surgery and not eating or drinking a few hours before surgery.
The surgery may be performed by arthroscopy (keyhole surgery) or open surgery if proximal bicep tenodesis is part of a larger surgery. Proximal bicep tenodesis may involve the following steps:
- You are given general anesthesia.
- A tiny incision is made by your surgeon.
- An arthroscope, which is a thin tube-like instrument with a camera, is inserted through the incision to visualize the joint.
- Your surgeon views the inside of the shoulder joint and the bicep tendon tear on a monitor and performs the necessary surgical repair.
- The injured tendon is detached from the shoulder joint (It may already be detached in the case of a complete tear).
- The frayed end of the long head of the bicep is clipped off.
- An anchoring device is used to reattach the tendon to the bone.
- The incision is closed, and a surgical dressing is placed.
After the procedure, pain medicine may be prescribed for a few days for comfort. The shoulder will be supported by a sling for a limited period, usually a month. Physical therapy may be recommended to maximize the range of motion and shoulder strength.