Arthroscopic Biceps Tenodesis / Tenotomy
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).
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
Who Needs This Treatment?
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Effectively eliminates chronic anterior shoulder pain from biceps tendon disease
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Arthroscopic day-case procedure — tiny incisions and rapid post-operative recovery
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Tenodesis maintains muscle function, strength, and normal arm appearance
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Tenotomy provides equally good pain relief with an even shorter recovery period
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Concurrent rotator cuff or labral pathology treated in the same procedure
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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
Arthroscopic Biceps Tenodesis / Tenotomy Cost in Hyderabad
The cost of arthroscopic biceps tenodesis or tenotomy in Hyderabad generally ranges from ₹80,000 to ₹1,60,000, with an average estimated cost of ₹1,20,000. The final expense depends on the type and severity of biceps tendon pathology, whether the procedure is performed alone or along with rotator cuff repair or other shoulder procedures, implant requirements, anesthesia, investigations, hospital stay and rehabilitation.
| Procedure | Approximate Cost Range |
|---|---|
| Biceps tendon pathology | ₹80,000 ₹1,60,000 |
| Associated biceps pathology | ₹80,000 ₹1,60,000 |
The above figures are approximate estimates and the final cost may vary depending on the patient's shoulder condition and the procedures required. Biceps tenodesis or tenotomy may be performed as an isolated procedure or together with rotator cuff repair and other arthroscopic treatments. The overall expense may include consultation, imaging, preoperative tests, surgeon and anesthesia charges, arthroscopy equipment, fixation devices when required, hospital stay, medicines and physiotherapy. Additional procedures may involve separate charges.
Factors Affecting the Cost of Arthroscopic Biceps Tenodesis / Tenotomy
The cost of biceps tenodesis or tenotomy depends on the extent of biceps tendon damage, associated shoulder conditions, surgical technique, implant requirements and whether additional procedures are performed during the same operation. Diagnostic investigations, anesthesia, hospitalization and postoperative rehabilitation can also influence the overall treatment expense.
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Biceps tendon condition: The severity and location of tendon pathology can affect treatment planning.
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Tenodesis versus tenotomy: The selected procedure depends on factors such as the patient's age, activity level, tendon condition and associated shoulder problems.
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Associated rotator cuff tear: When biceps pathology occurs with a rotator cuff tear, additional repair may increase the overall surgical cost.
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Labral or shoulder pathology: Associated labral injuries or other structural problems may require additional arthroscopic treatment.
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Fixation devices: Biceps tenodesis may require specialized fixation devices, which can affect implant-related expenses.
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Surgical complexity: The extent of tendon damage and other shoulder abnormalities can influence operating time and surgical requirements.
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Diagnostic investigations: X-rays, ultrasound or MRI may be required to assess the biceps tendon and associated shoulder structures.
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Anesthesia: Anesthesia charges depend on the procedure and the patient's medical condition.
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Hospital stay: Admission and postoperative monitoring requirements can contribute to the total cost.
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Physiotherapy: Rehabilitation after surgery may be recommended to restore shoulder movement and strength.
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Additional procedures: Rotator cuff repair, labral repair or other arthroscopic procedures performed during the same surgery may increase the overall expense.
Insurance Coverage for Arthroscopic Biceps Tenodesis / Tenotomy
Arthroscopic biceps tenodesis or tenotomy may be covered by health insurance when medically necessary, subject to the terms and conditions of the individual policy. Coverage can vary based on the procedure, implant limits, exclusions, waiting periods, hospitalization benefits and pre-authorization requirements. Patients should confirm their policy coverage with the insurer before surgery.
- Checking your policy coverage
- Cashless approval process
- Required documentation
- Insurance-related queries before the procedure
Dr. Sai Kishan
Orthopaedic & Joint Replacement Surgeon
Dr. Sai Kishan Sirasala is a Consultant Orthopaedic Surgeon at Lux Hospitals, Hyderabad, with expertise in orthopedic surgery, arthroscopy, sports medicine and joint replacement. Patients with biceps tendon problems, rotator cuff tears or related shoulder conditions can consult him for a detailed evaluation and treatment plan. During the consultation, the doctor may assess: Shoulder pain, weakness and movement limitations Biceps tendon symptoms and functional problems History of injury or repetitive shoulder activity Rotator cuff and labral involvement Clinical examination findings X-ray, ultrasound or MRI findings when required Whether tenodesis or tenotomy is appropriate Need for associated rotator cuff or other arthroscopic procedures Expected recovery and rehabilitation requirements The recommended treatment is determined based on the patient's symptoms, imaging findings, tendon condition, associated shoulder injuries and functional requirements.
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