I had a complete rupture of the proximal long head bicep tendon this week and am thinking of have having a biceps tenodesis surgery done. The orthopedic doc I saw says at my age (56 but, feel 30) he would not have the surgery done. I am very active ( lifting weights, off road motorcycle riding, etc). I am looking for opinions from those that have had this surgery done if it was worth it to them. In the last 5 years I have gone through rehab for knee ( Meniscus tear), hand tendon re-attachment and ulnar nerve release (elbow & wrist)surgery. Is this procedure way worse than any of those? Your comments would be appreciated to help me make my final decision. Thank you, Don
Most people here are not quite as well lived as those of us at the half-century mark, so have different viewpoints. Haha. That being said, my husband ruptured his bicep and did not have it fixed. While he does not work out in a gym, he is VERY active, building furniture, general woodworking, taking care of horses and farm chores, as well as being a lawyer and accountant. It does look a bit odd, but he doesn't care and it doesn't bother him. Considering all the headache, pain, lost time and expense as well as lost career that I've been through due to botched medical intervention, it was an excellent decision to leave it go.
There are risks with this surgery. The jury is out on whether a tenotomy or tenodesis is better. General rule is tenodesis for younger folk (go ahead, define "younger", I dare you!) Seems to me if you read these postings, if it doesn't bother you, why fix it? It isn't going to be put back the way it was, so you won't be gaining much of anything except possible headaches, re=surgeries, pain, months of PT, etc.
Good luck with your decision. *I* certainly wish I had not done it, although it would have been done anyway with the replacement. I had a tenodesis with endobutton, and had no problem.
I typed a long post about this. Don't know what happened to it. Anyway I think we have a lot of the similar issues and I just had both procedures.
I'm 52 yrs old. Very active in weightlifting and competitive club level tennis. I've just had my 10th surgery. 3 right knee, 2 left knee, 2 right shoulder, and within the last couple of months 2 left shoulder. I'm a lefty.
On 9/27 I had cuff debrided, labrum debrided( too torn to repair), SAD, and open a/c joint resection. The OS also did a tentotomy which surprised and horrified me. Through 2 pre op consults I asked him about this, told him another doc suggested I may need tendonesis. He told me not to worry about it. He wasn't going there. I was relieved. I am trim, muscular and care a lot about my guns. After surgery he told me he released the LHB because of my age. I feel like I'm still 30 and haven't lost a step even with all my surgeries. I'm flexible and fortunate that I heal quickly and tend to recover well.
I had a lot of cramping from the tenotomy and the deformity freaked me out. I ended up going back to my other OS who told me he could reattach the tendon but I could not wait because the LHB and biceps start scarring in and then it can't effectively be reattached. I didnt want to wait to see if the cramping stopped and then not be able to do anything about it. the deformity was not going to get any better.So after 2 months recovering from the 1st surgery I went back under the knife for reattachment on. 11/30. The surgery was done open and due to heavy scarring in it took over 2 hours for the OS to get at the tendon( he had to cut away some of the muscle) to reattach. I am thrilled with the outcome and like riderk it has not been much of an ordeal for me. The tough part was all of the down time before and after the sept surgery.
I started PT immediately for stretching out of concern about freezing up from sept surgery. My sling came off 12/30 and yesterday I was cleared for strengthening. At PT I was doing curls and some of the exercises I had to stop from the prior surgery. I had no pain except for feeling the insertion point at the extreme ROM. I feel very fortunate based on a lot of the experiences many on this post have had with tendonesis. My feeling is if the tendonesis doesn't work it can always be cut. That would be a lot easier then what I was forced to go through. I went to the gym today, kept it light but was ecstatic to have my bicep back. I was able to curl 15 lbs., do chest presses, push up and various cable exercises.OS said I can start hitting tennis ball in a couple of weeks when my strength starts to come back. I had been very depressed since this summer when my left shoulder finally gave out. Life is good and I'm feel very lucky.
If you're a weightlifter I don't think you'll be happy with the tentotomy. My ROM is better today then it was 2 months after the tentotomy. My OS feels that this isn't necessarily an age based issue but more of lifestyle and appearance.
I hope this helps
MJW & riderk,
Thanks for the quick responses as I have to make the decision by next Tuesday.
If I correctly understood you both, the tendonesis procedure was not too bad for either of you. MJW, after 2 months of experiencing the tentotomy and then having a tendosis, you are much happier with the the results from the tendosis. But riderk, when you said "*I* certainly wish I had not done it", were you referring to the tendosis or your earlier shoulder procedures? One last question- Is the tendosis a faster recovery than the shoulder operations you both had? Thanks again for the input. As I read in other posts on the site, "the decision is sometimes harder than the surgery", and I am in the decision stage still.
Personally speaking, of course, I am not sure it was necessary and since I had subsequent problems with superior instability, not sure that did not contribute to those problems. It is an unusual situation. That being said, it was a breeze recovery-wise. However, it is not the same as your situation at all - you already have a rupture - mine was intact. Your situation is more like my husband's. He did not have it repaired and has no adverse effects. He is 58 now, must've been about 12 years ago. I just asked him - no problem. He tore his lifting a really heavy pallet, and has gone on to do major outdoor physical labor around the farm. So is it worth the risks of surgery for not having slight imperfection (I see lots of them due to normal aging when *I* look in the mirror!) Is it going to give you more strength - apparently your surgeon doesn't think so. There will be scarring - that was part of my downfall and came out of nowhere (excessive scarring) or you could have other adverse events that others have suffered (infection, CRPS, etc.)