23440 Resection or transplantation of long tendon of biceps

Name of the Procedure:

Resection or Transplantation of Long Tendon of Biceps
Common name(s): Biceps tenodesis, Biceps tendon resection

Summary

The resection or transplantation of the long tendon of the biceps involves either removing a damaged section of the tendon or reattaching the tendon to a different part of the bone to alleviate pain and restore function.

Purpose

This procedure addresses conditions like biceps tendonitis, tears, or tendinopathy. The goal is to relieve pain, improve shoulder function, and prevent further injury by stabilizing the biceps tendon.

Indications

• Persistent shoulder pain and tenderness
• Biceps tendonitis or tendinopathy
• Partial tears of the biceps tendon
• Failed conservative treatments (e.g., physical therapy, medications)
• Sling symptoms, where the tendon is no longer stable in its groove

Preparation

• Fasting for 6-8 hours before the procedure
• Required imaging tests, such as MRI or ultrasound
• Possible medication adjustments (e.g., blood thinners)
• Preoperative physical assessment and consultation

Procedure Description

1. Anesthesia administration (general or local)
2. Making a small incision near the shoulder
3. Identification and isolation of the damaged biceps tendon
4. Either resecting (cutting) the damaged portion or reattaching (transplanting) the tendon to the humerus
5. Closing the incision with sutures or staples
6. Dressing the wound to prevent infection

Duration

Typically lasts about 1 to 1.5 hours.

Setting

Performed in a hospital or outpatient surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Possibly a surgical assistant or PA (physician assistant)

Risks and Complications

• Infection
• Bleeding
• Nerve or blood vessel damage
• Stiffness or weakness in the shoulder
• Adverse reactions to anesthesia
• Failure of the tendon to properly heal

Benefits

• Significant pain relief
• Improved shoulder function and strength
• Reduced risk of further tendon damage
• Enhanced quality of life

Recovery

• Immobilization of the shoulder using a sling for a few weeks
• Physical therapy for several months
• Gradual return to normal activities, avoiding heavy lifting or shoulder strain
• Full recovery typically within 3 to 6 months

Alternatives

• Non-surgical treatments (e.g., physical therapy, corticosteroid injections)
• Arthroscopic debridement (removal of damaged tissue)
• Conservative management (activity modification, medications)

Patient Experience

Patients may experience discomfort and swelling at the surgical site initially. Pain can be managed with prescribed medications. Gradual physical therapy will help regain strength and function, with most patients feeling improved mobility and less pain within a few months.