Biceps tendon ruptures

The biceps muscle in the upper arm commonly undergoes tendon ruptures either distally at the elbow as it inserts into the radial tuberosity, and less commonly in its long head at the shoulder. It occurs when the biceps contracts against a load that exceeds its tendon strength and this most commonly occurs in the setting of tendinopathy (chronically weakened tendon secondary to overuse most commonly seen in manual labourers and weightlifters).
A distal biceps tendon rupture leads to mild loss of strength in elbow flexion and a more significant (30%) loss of forearm rotation (supination) strength. It is also likely to cause chronic irritation at the elbow. It is usually recommended that a repair is performed acutely to restore biceps function. Dr Rae prefers a one incision technique using a biceps button, but would be happy to talk to you about the options.

Long head of biceps tendon ruptures in isolation occur less commonly  in younger people. They are relatively common in older people and are usually managed non-operatively.  There is less loss of strength associated with these proximal ruptures as the other proximal tendon of the biceps muscle is still intact. It will classically lead to a “popeye” sign where the muscle bulges in the middle of the upper arm and can be irritating. In younger (under 45) patients, particularly athletes and manual labourers, a biceps tenodesis is usually recommended. Tenodesis involves a tendon transfer to another location in the proximal humerus, becauses direct repair in the shoulder joint is not recommended. There are a number of techniques for this, but in this scenario Dr Rae’s preferred technique is to do a subpectoral tenodesis using a biceps button.

Since this is general information, Dr Hamish Rae, you experienced orthopaedic surgeon from Sydney, can offer you more information about your pain and the options for treatment that are available for you. Please call and make an appointment at 80055111.