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Indications for operation
Rupture of the long head of biceps causing pain which has not responded to conservative treatment
All surgical procedures have some element of risk attached. Click here to view/hide this information.
Risks associated with LHB Tenodesis
All surgical procedures have some element of risk attached.
The risks outlined below are the most common or most significant that have been reported.
Continued pain / weakness: 5%
In the majority of cases all the pain is removed by surgery however occasionally a small amount of pain persists. This is usually mild but very rarely (less than 1%) can be the same or worse than prior to surgery.
Infection: less than 0.1%
If an infection does occur it is usually superficial in the wounds and is easily treated with antibiotics.
Rarely the infection can be deep inside the joint and this requires surgery to wash the joint out.
Nerve damage: less than 0.1%
The axillary nerve runs close to the bottom of the joint and, if damaged causes weakness of the deltoid muscle and difficulty in raising the arm.
Stiffness: 1%
The shoulder will often become stiff after surgery and this usually settles with physiotherapy. Rarely the shoulder can become very stiff and require manipulation or arthroscopic release surgery.
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
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
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 wear the sling for 4 weeks.
