Specialized Elbow Care in Colorado Springs

Biceps Tendon Repair

Colorado Springs Orthopaedic Group

Your elbow connects the upper and lower arm and plays an important role in lifting, reaching, gripping, and other everyday movements. Elbow injuries and conditions can result from sports, repetitive use, trauma, arthritis, or problems affecting the tendons, nerves, and surrounding tissues.

At CSOG, our specialists provide comprehensive care for a wide range of elbow conditions, including tendon injuries, nerve compression, instability, arthritis, fractures, and sports-related injuries. Treatment is based on your diagnosis and may range from conservative care and physical therapy to injections, minimally invasive procedures, and surgery.

Our goal is to identify the source of your elbow problem and provide an individualized treatment approach that helps relieve pain, restore movement and strength, and return you to your normal activities.

• Request An Appointment

What is Biceps Tendon Repair?

Biceps tendon repair is a surgical procedure to restore a biceps tendon that has been torn or ruptured by severe trauma or injury.

The biceps is a large muscle located in the front of your upper arm and runs from the shoulder to the elbow joint. It helps in bending your elbow as well as in rotational movements of your forearm. It also helps to maintain stability of the shoulder joint. The biceps muscle has two tendons, one of which attaches to the bone in the shoulder, and the other to the elbow. A biceps tendon tear can be either partial or complete. Partial biceps tendon tears will not completely cut the tendon. Complete tendon tears sever the tendon into two parts.

Most cases of small or partial ruptures are treated with a nonsurgical approach, whereas a complete rupture will need surgical intervention. The goal of the surgery is to re-attach the torn tendon to the bones in the shoulder and elbow, and to restore normal function of the arm.

What are the Indications for Biceps Tendon Repair?

Biceps tendon repair is often indicated for the treatment of a biceps tendon tear due to injuries sustained falling with the arm outstretched, or during the act of lifting a heavy object. In cases of overuse, a tendon may fray and eventually tear. Other shoulder problems such as tendonitis, shoulder impingement, and rotator cuff injuries are likely to weaken or tear the biceps tendon. Additional risk factors such as advancing age, heavy or repetitive overhead activities or sports, smoking, and the use of corticosteroids can also result in a tendon tear.

What is the Procedure for Biceps Tendon Repair?

The biceps tendon attaches the biceps muscle to the bones in the shoulder and elbow. A biceps tendon tear at the shoulder is called a proximal biceps tendon tear, while a biceps tendon tear at the elbow is a distal biceps tendon tear.

Distal Biceps Tendon Repair

The distal biceps is the area where the biceps attaches to the forearm bone in the elbow. The distal biceps is usually repaired through a single incision (front of the elbow) or a double incision (front and back of the elbow) technique. During the procedure:

• You will be administered general anesthesia.
• A small incision is made at the elbow, and the torn or ruptured end of the biceps located.
• Any damaged tissues are removed using specialized instruments.
• Small holes are then drilled into your forearm bone (radius bone).
• A tiny metal implant known as an anchor is pressed into the forearm bone.
• Strong threads (sutures) are inserted into the distal biceps tendon.
• The sutures are attached to the anchor and the biceps is pulled back.
• The biceps is reattached and fixed to the forearm bone with strong anchoring stitches.
• The incision is closed with stitches and a dressing is applied.

Proximal Biceps Tendon Repair

The proximal biceps tendon repair is achieved through a procedure called biceps tenodesis. 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.

The surgery may be performed by arthroscopy (keyhole surgery) or open surgery if proximal bicep tenodesis is part of a larger surgery. Proximal biceps 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 biceps 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 biceps is clipped off.
• An anchoring device is used to reattach the tendon to the bone.
• The incision is closed, and a surgical dressing is applied.

What Does Postoperative Care for Biceps Tendon Repair Involve?

In general, postoperative care and recovery after biceps tendon repair involve the following steps:

• You will be transferred to the recovery area where your nurse will closely observe you for any allergic/anesthetic reactions and monitor your vital signs as you recover.
• You may need to stay in the hospital for a day or two before discharge.
• You may notice pain, swelling, and discomfort near the surgery site. Pain and anti-inflammatory medications are provided as needed.
• Application of ice packs to the affected area is also advised to prevent stiffness and swelling.
• You are advised to keep your arm elevated above your chest for few days while resting to decrease swelling and pain.
• You will be placed in a sling or a splint for the first few weeks with instructions on restricted activities.
• You are encouraged to gently exercise your fingers, elbow, and shoulder to prevent stiffness.
• Physical therapy and range-of-motion exercises are recommended after the first follow-up visit to restore mobility and strengthen the elbow and shoulder muscles.
• You should keep the surgical site clean and dry. Instructions on surgical site care and bathing will be provided.
• Refrain from strenuous activities or lifting heavy objects for at least a couple of months. Gradual increase in activities over a period of time is recommended.
• Most patients are able to resume their normal activities in a month or two after surgery; however, return to sports may take 6 to 12 months.
• Do not drive until you are fully fit and receive your doctor’s consent.
• Periodic follow-up appointments will be scheduled to monitor your progress.

What are the Risks and Complications of Biceps Tendon Repair?

Biceps tendon repair is a relatively safe procedure; however, as with any surgery, some risks and complications may occur, such as:

• Pain
• Bleeding
• Infection
• Injury to nerves or vessels
• Anesthetic/allergic reactions
• Decreased strength and sensation
• Decreased range of motion
• Numbness, tingling, or weakness
• Re-rupture of the repaired tendon
• Need for additional surgery