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Surgical treatment of injury or tearing of the long head of the biceps tendon generally consists of either biceps tenotomy or tenodesis. In a tenotomy, the biceps tendon is cut and once it is released from its attachment in the shoulder joint, it falls out of the shoulder joint and into the upper arm. Many people can live normal lives with the tendon loose in the arm but some people feel discomfort and weakness in the arm and require further treatment. Some people, bodybuilders especially, are troubled by the appearance of the cut tendon as it is externally visible, which is known as the ‘Popeye’ effect. In such cases where further treatment is necessary, a biceps tenodesis is performed.
Biceps tenodesis is generally performed on younger patients and more active individuals such as athletes and can be performed using open as well as arthroscopic techniques. These techniques can be especially useful when used in conjunction with rotator cuff and shoulder labrum repair. A biceps tenodesis is a surgical procedure that detaches the biceps from its attachment on the superior labrum and reattaches it to the humerus. This can be performed using suture anchors, tenodesis screws and even interference screws to name a few of the more popular devices. Surgeons are beginning to perform tenodesis procedures as a primary measure rather than performing a tenotomy and waiting for the outcome.
Abstract The tendon on the long head of the bicep attaches the bicep muscle to the top of the glenoid fossa. Most bicep tendon injuries occur at the long head due to its proximity to the rotator cuff and the acromion. When the elbow is straight, this long head tendon acts as a secondary stabilizer of the shoulder and therefore strenuous and repeated overhead movements can lead to injury or tearing of the tendon. It is possible for patients to live with a bicep tendon injury or tear but as the level of discomfort increases or the level of functionality decreases, a surgical procedure is necessary.
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