What is the role of tenodesis in the treatment of bicipital tendonitis?

Updated: Nov 21, 2018
  • Author: Britt A Durham, MD; Chief Editor: Sherwin SW Ho, MD  more...
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Answer

Tenodesis is not recommended when it is believed that the tendinitis is reversible. Specific indications for tenodesis of the biceps long head include the following [7, 27] :

  • Greater than 25% partial-thickness biceps tendon tear

  • Severe subluxation from the bicipital groove

  • Disruption of the associated bony or ligamentous anatomy of the groove itself

  • Biceps tendon atrophy greater than 25%

  • Failure of surgical decompression

Growing evidence has shown a shift from routine tenodesis to a more individual approach, with considerations such as physiologic age, activity level, expectations, and specific combinations of shoulder pathology as important factors. [7] Although new repair techniques continue to be developed, the preference is for preservation of the biceps-labral complex rather than routine surgery. When surgery is performed for bicipital tendinitis, the procedure is typically performed through an open anterior incision. Variations of this surgery include arthroscopic techniques and open exposures with suture anchors through the subclavian portal. Subpectoral biceps tenodesis has proven to be an effective procedure to relieve pain and maintain function. [28]


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