Postoperative management of biceps tenodesis is dependent on any associated procedures that were performed. In the case of a concomitant rotator cuff tear, postoperative rehabilitation is focused on protecting the rotator cuff tear. Passive range of motion is initiated, followed by active range of motion for 6 weeks before strengthening exercises are allowed. In cases in which an isolated tenodesis was performed, passive pendulum and active wrist and elbow exercises are started immediately. Gentle shoulder passive range of motion is initiated at 1 week after surgery, and a sling is used for 4 weeks. Active biceps flexion is avoided for 6 weeks. By 8 weeks, active range of motion and gentle strengthening of the shoulder can progress. The patient should be on a home exercise program by 3 to 4 months, and full recovery with unrestricted activity is expected by 4 to 6 months after surgery.
Figure 24-9 Photograph in the subacromial space showing the tied sutures of the completed percutaneous transtendon intra-articular biceps tenodesis. (From Sekiya LC, Elkousy HA, Rodosky MW: Arthroscopic biceps tenodesis using the percutaneous intra-articular transtendon technique. Arthroscopy 2003;19:1137-1141.)
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