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Biceps Tendon Rupture Surgery

The surgical procedure you will have to undergo if you have a biceps tendon rupture is usually minimally invasive by virtue of advanced medical technology. Connecting the muscle known as the biceps to the shoulder and forearm, the biceps tendon is a long structure that resembles a cord. The purpose of surgery for a biceps tendon rupture is to either trim the tendon or move it and attach the torn tendon to the arm bone, a procedure known as tenodesis. However, the type of surgery you will undergo for a biceps tendon rupture will ultimately depend on the nature and degree of damage, as well as on how much pain it causes you.

The biceps can rupture proximally, at the shoulder, or distally, at the elbow. A rupture typically occurs when unexpected force is applied to the biceps muscle, such as trying to catch someone who is falling. The vast majority of biceps ruptures occur when the elbow is in a flexed position. The objective of the procedure is to restore the range of motion and strength of the elbow. Some individuals will not be good candidates for minimally invasive surgery and will instead undergo traditional surgery.

Firstly, the surgeon will make a small incision over the upper forearm, which is where the biceps muscle attaches to the radius bone. The damaged biceps tendon is brought up through the incision. During the procedure, the surgeon reattaches the tendon to the radius bone by using either sutures or anchors with sutures. Ideally, the patient with a biceps tendon rupture should undergo surgery within 2 to 3 weeks from their injury. If they wait longer, the tendon and the biceps muscle will start to scar and shorten, which can make it impossible for the surgeon to restore arm function.

The primary goal of the surgery is to reattach the biceps tendon to the radius bone, as this is the only way it can heal and become functional again. This surgical procedure is usually performed outpatient, which means that you will be able to go home the same day after spending only several hours in the hospital. It is important to note that distal biceps tendon ruptures, which are those that occur at the elbow, nearly always require emergency surgery, as otherwise, the patient has a high risk of losing considerable functioning of their arm.

Naturally, the main benefit of biceps tendon rupture surgery is the restoration of the normal function of the biceps tendon, which will allow you to use your arm properly following the procedure. People who benefit the most from this surgery are young athletes, especially gymnasts, as they can return to approximately the same level of competition after surgical repair. Other notable benefits of this surgery are the following:

• restoring strength and endurance to the biceps muscle
• maintaining range of motion in the elbow joint
• the disappearance of pain in your shoulder or elbow
• no more weakness in your shoulder or elbow
• being able to rotate your arm without discomfort

Recovery

The full recovery period after you undergo surgery for biceps tendon rupture is one year. You will have a series of restrictions with regard to how you can use your arm during the first several months following the procedure. For the first 4 weeks, you will have to wear a sling so as to protect the area of the arm that was surgically repaired.

At some point during your recovery, you will also have to do physical therapy, whose purposes are to completely restore your range of motion and to strengthen your arm. Some patients will be recommended to do physical therapy just 2 days after they have had their surgery. The duration of physical therapy is generally 12 to 16 weeks for a biceps tendon rupture.

You will be allowed to return to your normal activities without any restrictions after 14 to 20 weeks following the surgery, depending on how severe your injury was. How much time you will have to spend in recovery highly depends on whether the rupture occurred at your shoulder or at your elbow.

Risks

While biceps tendon rupture surgery is usually safe and effective, it also implies a series of risks, just like any other invasive procedure, some of which are the following:

• the formation of bone in soft tissue, where it should not exist
• experiencing a second rupture of your biceps tendon
• superficial wound infection
• nerve injury in your arm

Nevertheless, with adequate and constant medical supervision, your chances of experiencing these risks will be minimal.

Complications

Distal biceps tendon repair surgery has a 7.5% rate of major complications and a 4.5% reoperation rate. These are the complications that can arise following the surgical repair of a ruptured biceps tendon:

• proximal radioulnar synostosis, which occurs when the radius and ulna fuse
• loss of range of motion if the patient undergoes a second surgery
• complete tendon rupture
• deep infection
• posterior interosseous nerve palsy, which causes weakness in the muscles
• complex regional pain syndrome

Because your health will be thoroughly evaluated before you undergo surgery, the risk of experiencing these complications after biceps tendon rupture surgery is relatively low. Our surgeons have performed numerous surgeries for the repair of the biceps tendon, so you should not worry about the risks and seek the care you need.