Arthroscopic Biceps Tenodesis & Tenotomy
Arthroscopic release and relocation of the long head of biceps tendon — resolving persistent anterior shoulder pain caused by biceps tendon inflammation, instability, or partial tearing.
What is Arthroscopic Biceps Tenodesis & Tenotomy?
The long head of the biceps tendon (LHBT) originates inside the shoulder joint at the superior glenoid and travels through the bicipital groove on the humerus. When inflamed, partially torn, or subluxed from its groove, the LHBT is a common cause of anterior shoulder pain that does not resolve with physiotherapy or injections. Two surgical options exist: biceps tenotomy (simple release of the tendon from its attachment — quick, effective, preferred in older patients) and biceps tenodesis (release and reattachment of the tendon to the humerus at a lower level — preserving biceps length and strength, preferred in younger, active patients who are concerned about the cosmetic 'Popeye' deformity of a simple tenotomy).
Suitable for patients with confirmed LHBT pathology — tendinitis, partial tear, instability in the groove, or involvement in a SLAP tear — that has failed 3+ months of conservative treatment. Tenotomy is preferred in patients over 60 or lower-demand individuals; tenodesis for patients under 55–60 or those with cosmetic or strength concerns.
How the Procedure Works
Diagnostic Arthroscopy
The LHBT is fully inspected — degree of tendinitis, tearing, subluxation, and its relationship to any SLAP tear are documented.
Tenotomy (if selected)
The LHBT is released from its superior glenoid origin with an arthroscopic electrocautery or scissors — the tendon retracts and the pain source is eliminated immediately.
Tenodesis — Release
For tenodesis, the tendon is released intra-articularly as above and retrieved in the subpectoral or bicipital groove region.
Tenodesis — Reattachment
The retrieved tendon is secured to the humerus using a bioabsorbable screw, suture anchor, or cortical button — restoring biceps length and tension.
Recovery
Sling for 2–4 weeks (tenotomy) or 4–6 weeks (tenodesis); progressive physiotherapy follows.
Outcomes
Who Needs This Treatment?
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Resolves persistent anterior shoulder pain from LHBT pathology
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Day-care procedure — no overnight admission required
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Tenotomy option: immediate relief with minimal recovery time
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Tenodesis option: preserves biceps contour, strength, and supination power
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Frequently combined with rotator cuff repair or impingement decompression
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Excellent patient satisfaction in appropriately selected cases
"Biceps tendon problems are underdiagnosed as a cause of shoulder pain. When the tendon is the culprit, releasing or relocating it is quick, effective, and transformative — patients are often amazed that a pain they have had for years is gone after a 30-minute procedure."
— Dr. Satish Reddy Gandavarapu, Senior Orthopaedic Consultant and Trauma Surgeon , Lux Hospitals, Hyderabad
Arthroscopic Biceps Tenodesis / Tenotomy Cost in Hyderabad
The cost of Arthroscopic Biceps Tenodesis / Tenotomy in Hyderabad generally ranges from ₹80,000 to ₹1,60,000, with an indicative average cost of around ₹1,20,000. These procedures may be performed to address selected conditions affecting the long head of the biceps tendon, often in association with other shoulder problems. The final cost depends on the diagnosis, surgical technique, implant requirements and whether additional procedures are performed during the same surgery.
| Procedure | Approximate Cost Range |
|---|---|
| Arthroscopic Biceps Tenodesis / Tenotomy | ₹80,000 – ₹1,60,000 |
The above range is indicative; the final package and inclusions should be confirmed with the hospital before publication. The final cost may vary when biceps treatment is combined with rotator cuff repair, labral surgery or other shoulder procedures.
Factors Affecting the Cost of Arthroscopic Biceps Tenodesis / Tenotomy
The overall cost can vary depending on the condition of the biceps tendon, whether tenodesis or tenotomy is selected, the surgical approach and whether other shoulder procedures are required during the same operation.
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Biceps tendon condition: The extent of tendon damage, inflammation, degeneration or instability may influence the surgical plan and the complexity of treatment.
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Tenodesis versus tenotomy: The choice between tenodesis and tenotomy depends on factors such as age, activity level, tendon pathology, shoulder condition and the surgeon's assessment. Tenodesis may require fixation using a specialised implant.
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Associated shoulder conditions: Biceps pathology may occur alongside rotator cuff tears, labral problems or other shoulder conditions. Treating these conditions during the same surgery can increase the overall package cost.
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Implants and consumables: Biceps tenodesis may require suture anchors or other fixation devices, and the type and number of implants used can affect the final cost.
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Anaesthesia and hospital charges: Operating-room charges, anaesthesia, medicines, arthroscopic equipment and day-care or hospital observation may be included according to the hospital's package structure.
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Rehabilitation requirements: Recovery and physiotherapy requirements depend on the procedure performed and any additional shoulder surgery. Rehabilitation costs may be separate from the surgical package.
Insurance Coverage for Arthroscopic Biceps Tenodesis / Tenotomy
Arthroscopic Biceps Tenodesis / Tenotomy may be covered by health insurance when medically necessary, subject to the patient's policy terms, exclusions, waiting periods, insurer approval and hospital coverage arrangements. Patients should confirm pre-authorisation requirements and applicable coverage with their insurer before treatment.
- Checking your policy coverage
- Cashless approval process
- Required documentation
- Insurance-related queries before the procedure
Dr. Satish Reddy Gandavarapu
Orthopaedic & Joint Replacement Surgeon
Dr. Satish Reddy at Lux Hospitals, Hyderabad, can evaluate patients with persistent shoulder pain, biceps-related symptoms or associated shoulder conditions and help determine whether Arthroscopic Biceps Tenodesis or Tenotomy is appropriate based on clinical examination and diagnostic findings. During the consultation, the doctor may assess: Shoulder and arm symptoms: The doctor may review pain in the front of the shoulder, weakness, clicking, discomfort during lifting or overhead activities and other symptoms associated with biceps tendon pathology. Physical examination: Shoulder range of motion, strength, tenderness and specific clinical tests may be performed to assess the biceps tendon and identify associated shoulder problems. Imaging findings: X-rays, ultrasound or MRI reports may be reviewed when available to assess the biceps tendon, rotator cuff, labrum and other shoulder structures. Associated conditions: The doctor may assess whether a rotator cuff tear, labral injury, shoulder instability or another condition is contributing to the patient's symptoms. Previous treatment: Physiotherapy, activity modification, medicines, injections and other non-surgical treatments may be discussed along with the patient's response to these measures. Procedure selection: Based on the patient's age, activity level, tendon condition and associated pathology, the doctor may discuss whether tenodesis, tenotomy or another treatment approach is appropriate.
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