Open Biceps Tendon Repair

An open biceps tendon repair (or tenodesis) is the surgical treatment for a ruptured biceps tendon. Most biceps tendon ruptures occur when lifting heavy objects or when the arm is stressed during elbow flexion. Tenodesis means to reattach a tendon. This can be done for biceps tendon ruptures that occur at the shoulder or elbow attachment. When the rupture occurs at the shoulder, the biceps tendon does not need to be reattached for full function; however, a lot of patients have it fixed to restore the look of the biceps muscle. A rupture that occurs at the elbow must be reattached or the patient will lose motion of the elbow and be unable to perform certain movements with the arm.

Biceps tenodesis is an open procedure, meaning it requires either one or two incisions. Reattachment at the shoulder is done through an approximately half-inch incision on the inside of the arm close to the axilla. For reattachment at the elbow, a two-incision approach is utilized. At the elbow, the first incision is at the crease where the elbow bends. The second incision is on the back of the forearm. Regardless the number of incisions, the surgery is similar. First the ruptured tendon is located by the surgeon. Once located, the end of the tendon is cleared of any damaged tissue so the tendon has a fresh edge. Then the end of the tendon is reattached down to the bone with strong suture known as Fiberwire. If necessary, an additional screw or peg may be inserted for extra fixation of the tendon to bone.

Post Operative Instructions:

SLING/MOVEMENT

If you underwent a surgery to reattach your biceps tendon at the elbow attachment, then you will be placed in a soft cast for 1 week after your surgery. This will limit the movement of your elbow as to not disrupt your biceps tendon repair. You will also be given a sling that you may wear for comfort.

You may move your shoulder in any direction that is comfortable. Do not force the motion though because this will likely cause pain.

MEDICATIONS

An injection of local anesthesia was injected into your shoulder after the completion of the operation. This medication will wear off in 5 to 6 hours. Therefore, begin taking the pain medication (e.g. Vicodin, Percocet, etc) immediately when you get home. This will prevent you from having severe pain. Take the pain medication every 4 hours until you go to bed.

The day after surgery you can take 600 mg of Ibuprofen (Advil/Motrin) every 6 hours to help with inflammation and pain. This medication will help cut down the use of narcotic-based pain medication. However, if you still have pain after taking the Ibuprofen, continue taking the pain medication every 4-6 hours as needed.

A sleeping medication (e.g. Ambien) is also provided to help you sleep at night. Take one tablet 30 minutes before you plan to sleep.

DRESSING/BANDAGES

Your dressing is NOT waterproof, therefore you are not to get your soft cast wet. You can bathe; however, will need to cover your arm with a plastic bag or trashbag to avoid getting your incisions wet

Your soft cast will be removed at your first post-op visit at which point you will be allowed to start getting your incisions wet.

APPOINTMENT

  • Please call the office prior to, or immediately following, your surgery in order to schedule a postoperative appointment. This should be scheduled 7-10 days after surgery. At that visit your stitches will be removed and you will be given a prescription to begin physical therapy.

If you have any questions or concerns, please contact our assistant at (310) 659-2910 extension 3048.

Download the postoperative instructions for your procedure (PDF) 

Recovery Timeline:

Day of surgery: Arrive one to two hours prior to surgery. Procedure will take approximately one to one and a half hours, and recovery time is one hour. For immediate post-op instructions, download the instruction sheet.

One week post-op: First follow-up visit with Dr. Snibbe/Jennifer. Your cast will be removed, and your stitches will be taken out. Start icing the surgical area two to three times a day (or more if needed). Discontinue the sling as soon as possible to avoid stiffness. Physical therapy will be prescribed. Start physical therapy immediately to work on range of motion. Do not do any active biceps exercises or hold anything in that hand (not even a cell phone) for the first month after surgery.

Four weeks post-op: Second follow-up visit. Range of motion and strength test. Physical therapy will continue to improve range of motion. Mild stiffness is still common. You can start active biceps exercises, but still no resistance. You can start holding up to 2 lbs. in your hand (cell phone, coffee mug, etc.).

Eight weeks post-op: Third follow-up visit. Range of motion and strength testing. If additional range of motion or strength training is needed, continue physical therapy to work on these. Pain should be mostly resolved at this point.

Twelve weeks post-op: Fourth follow-up visit. Range of motion should be full/normal. You should feel stronger and have very little pain, if any. Near to full recovery is expected at this time.






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