How can surgery help a rotator cuff tear if the biceps tendon is involved?

Kristofer J. Jones, MD
Orthopedic Surgery
There are two types of procedures that can be done to address the biceps tendon if it's a problem in conjunction with rotator cuff pathology:
  • Tenotomy: In a tenotomy, doctors cut the tendon and remove it from the shoulder joint. The consequence of this is that you can get a little cramping with repetitive elbow flexion and forearm rotation. Also, some people notice a small bulge due to the loss of the normal resting tension of the muscle. The muscle develops a slightly prominent bump that's called a Popeye deformity because of its resemblance to the cartoon character's arms. This is a small cosmetic deformity.
  • Tenodesis: If the doctor and patient anticipate the aforementioned problems with a tenotomy may be an issue for a patient’s lifestyle, we can perform a tenodesis instead. After cutting the tendon, doctors can make a small incision to reattach the tendon to the bone (tenodesis).
Barry Kraushaar, MD
Orthopedic Surgery
Rotator cuff tears commonly occur at the same time as biceps tendon injuries in the shoulder. When a surgeon looks in the shoulder he can see both problems at the same time. While repairing the rotator cuff, the surgeon may decide that it is necessary to operate on the biceps tendon as well. Procedures to repair the tendon depend on the severity of the injury. For example, a frayed tendon may need to be derided, or cleaned up. A nearly torn tendon may be cut/released. It may be very helpful to perform a biceps release in active or elderly patients. In younger or active patients, a procedure called biceps tenodesis is performed, reattaching the damaged biceps to bone for a solid repair. Commonly the rotator cuff repair and biceps tendon surgery is performed through the same incision.

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