Indications for operation

Rupture of the long head of biceps causing pain which has not responded to conservative treatment

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Anaesthetic

General Anaesthetic with an interscalene block (You will be fully asleep and a local anaesthetic injection into the side of the neck will numb the nerves to the shoulder for post-operative pain relief)

Operation type

Open or Arthroscopic

Arthroscopic Procedure

Incisions

4 5mm incisions will be made around the shoulder. One at the back, one at the front and 2 at the side

Procedure

The tendon is released from the bone inside the joint and the damaged portion is removed. A small hole is drilled in the front of the humerus and the tendon stump is secured into the hole using a special “interference screw”.

Images

Animation of the Arthrex Swivelock technique for biceps tenodesis

Wound Closure

Paper stitches (steristrips) are used to close the wounds.

Dressings

Elastoplast dressings will be placed over the top of the paper stitches and an adhesive bandage over the top of this.

Immediate aftercare

You will wake up with a sling on the arm and your arm may feel numb for the rest of the day. You can go home when you feel comfortable but will need to protect the arm for 4 weeks which may include the use of a sling.

Instructions for rehabilitation

Open Procedure- Subpectoral Biceps Tenodesis

Incisions

An 5cm incision will be made in the in the axilla (armpit) just under the edge of the pectoralis major muscle (the large muscle at the front of the chest).

Procedure

The muscles and tendons of the upper arm are moved to each side and the ruptured (torn) end of the long head of biceps tendon is identified. The muscle is freed as much as possible but it is usually not possible to restore it to its pre-injury position. A small hole is drilled in the front of the humerus and the tendon stump is secured into the hole using a special “interference screw”.

Images

Procecure for Subpectoral Biceps Tenodesis

Wound Closure

A single long dissolving stitch under the skin and paper stitches over the top will be used to close the wound.

Dressings

Elastoplast dressings will be placed over the top of the paper stitches and an adhesive bandage over the top of this.

Immediate aftercare

You will wake up with a sling on the arm and your arm may feel numb for the rest of the day. You can go home when you feel comfortable but will need to protect the arm for 4 weeks which may include the use of a sling.

Instructions for Rehabilitation