✦ Targeted Shoulder Procedure

Arthroscopic Biceps Tenodesis / Tenotomy

Q: How do tenotomy and tenodesis differ in terms of outcome?

Both achieve equivalent pain relief. Tenotomy involves no fixation and allows faster recovery; tenodesis preserves biceps strength and prevents the Popeye cosmetic deformity. Active individuals, manual workers, and athletes typically benefit most from tenodesis.

Q: Will arm strength be affected after a biceps tenotomy?

Clinical studies show that most patients experience negligible functional loss. A modest reduction in forearm supination strength may occur, which is rarely noticeable in daily life. Patients requiring maximal supination strength — such as manual workers — may prefer tenodesis.

Q: What is the Popeye deformity and how is it avoided?

Following tenotomy, the released biceps muscle belly can fall distally, creating a cosmetic bulge in the lower arm. Biceps tenodesis reattaches the tendon at a lower humeral level, preventing this appearance and maintaining normal arm contour.

Q: How long does recovery from biceps tenodesis take?

A sling is used for 2–4 weeks. Light activities resume at 4–6 weeks. Full return to overhead sport, heavy lifting, and manual work typically takes 3–4 months as the tenodesis attachment site heals and strength is progressively restored.

Chronic anterior shoulder pain from a damaged biceps tendon is eliminated by either releasing the tendon from its attachment (tenotomy) or repositioning it at a lower point on the bone (tenodesis).

30–60 min PROCEDURE

Day Care HOSPITAL STAY

>90% SUCCESS RATE

3–4 Months FULL RECOVERY

What is Arthroscopic Biceps Tenodesis / Tenotomy?

The long head of the biceps tendon passes through the shoulder joint and over the humeral head before entering the bicipital groove. When inflamed, partially torn, or unstable within the groove, it becomes a persistent source of anterior shoulder pain. Tenotomy simply releases the tendon from its labral attachment, immediately removing the pain generator with minimal rehabilitation required. Tenodesis releases the tendon and reattaches it to the humerus at a lower level, preserving the muscle's mechanical function and preventing the cosmetic bulge that can follow tenotomy. Dr. Sai Kishan tailors the decision between the two approaches at Lux Hospitals based on age, activity requirements, and physical demands.

Indicated for patients with persistent anterior shoulder or bicipital groove pain from biceps tendon pathology — including partial tears, instability, and SLAP lesions — that has not responded to a dedicated course of physiotherapy and steroid injection. Tenotomy suits older patients; tenodesis is preferred for active individuals.

How the Procedure Works

Anaesthesia & Positioning

General or interscalene regional block; the patient is placed in beach-chair or lateral decubitus position for arthroscopic access.

Glenohumeral Assessment

A complete arthroscopic survey of the shoulder joint assesses biceps anchor integrity, labrum, rotator cuff, and cartilage surfaces.

Biceps Tenotomy (where selected)

The tendon is cleanly released from its superior labral attachment using an arthroscopic radiofrequency device; pain relief is typically immediate.

Biceps Tenodesis (where selected)

After releasing the tendon, it is pulled distally and secured to the humerus — subpectoral or suprapectoral — with an interference screw or suture anchor.

Closure & Sling Application

Portals are closed; a sling is worn for 2–4 weeks and physiotherapy gradually restores shoulder motion and strength.

Outcomes

30–60 minDURATION

Day CaseHOSPITAL STAY

>90%SUCCESS RATE

3–4 MonthsRETURN TO SPORT

Who Needs This Treatment?

→Effectively eliminates chronic anterior shoulder pain from biceps tendon disease
→Arthroscopic day-case procedure — tiny incisions and rapid post-operative recovery
→Tenodesis maintains muscle function, strength, and normal arm appearance
→Tenotomy provides equally good pain relief with an even shorter recovery period
→Concurrent rotator cuff or labral pathology treated in the same procedure
→High satisfaction rates — over 90% of patients report significant lasting pain relief

Few procedures deliver a more dramatic and immediate reduction in shoulder pain than a biceps release — patients who have had anterior shoulder discomfort for months often notice a difference before they leave the recovery room.

— — Dr. Sai Kishan Sirasala, Knee and Hip Joint Replacement & Robotic Surgery

Common Questions

Frequently Asked

How do tenotomy and tenodesis differ in terms of outcome?+

Will arm strength be affected after a biceps tenotomy?+

What is the Popeye deformity and how is it avoided?+

How long does recovery from biceps tenodesis take?+

Not sure which treatment is right for you?

Book a consultation with Dr. Sai Kishan and get a personalised treatment plan.

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