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Bicep Tenodesis


Biceps tenodesis is a surgical procedure used to treat biceps tendonitis, which is also known as a biceps tendon tear. This procedure is recommended for people with biceps tendonitis who experience shoulder pain caused by inflammation that did not improve through non-surgical treatment. It is also recommended to people who need to regain strength and mobility in their shoulder after a biceps tendon tear. The procedure itself involves removing the damaged portions of the biceps tendon and reattaching it.


Your shoulder is a ball-and-socket joint that consists of 3 bones: your collarbone (clavicle), your shoulder blade (scapula), and your upper arm bone (humerus). The head of your upper arm bone fits into a rounded socket (the glenoid) in your shoulder blade. A combination of tendons and muscles, known as the rotator cuff, helps keep your arm bone centered in your shoulder socket. The upper end of the biceps muscle has two tendons that attach it to the bones in the shoulder. The long head attaches to the top of the shoulder socket (glenoid). The short head attaches to a bump on the shoulder blade called the coracoid process.

Bicep Tenodesis graphic


Biceps tenodesis is a surgical procedure used to treat biceps tendonitis of the shoulder.

Biceps tendonitis, also known as a biceps tendon tear at the shoulder, occurs due to either abrupt injury, or over time through overuse. The tendon itself can either tear partially or entirely. Most people will be able to continue living their lives without ever having to get surgery. A biceps tendon tear will cause you to lose some strength and mobility in your shoulder, but not enough to make a difference in your daily activities. But people who need to regain full mobility and strength of the shoulder will need to get surgery.

There are several different ways a biceps tenodesis procedure is done, but they all fit into two different categories: soft tissue and hard tissue techniques.

The two main soft tissue techniques are:

  • Open keyhole procedure: An opening in the humerus, also known as a keyhole, is created and then using tiny instruments, a rolled-up end of the bicep is stitched into place.
  • The Pitt technique: two needles are used to develop an interlocking pattern of sutures and then tie the tendon to a shoulder ligament.

The two main hard tissue techniques are as follows:

  • The biceps tendon is first detached. A hole is then created at the top of the arm bone. One end of the tendon is attached to the hole while the rest of the tendon is secured by screwing it to the bone.
  • The biceps tendon is detached and then reattached to a button slid into a hole at the top of the arm bone.

Your Florida Orthopaedic Institute physician will determine the right version of biceps tenodesis for you.

Next Steps

Biceps tenodesis has a high success rate. Most people who get the procedure report less pain, better flexibility and strength of their shoulder and can return to their sports and activities. The procedure itself is thought to be most successful when performed three months after the initial injury.

Contact your Florida Orthopaedic Institute physician today to learn more about biceps tendonitis.

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