Tendons are strong, flexible cords of connective tissue linking muscles to bones throughout the body. This connection is fundamental for generating movement, maintaining stability, and enabling physical activities. However, these structures can be vulnerable to injury or degenerative conditions, which can compromise their integrity and disrupt musculoskeletal function. When damaged, specialized medical interventions become necessary to restore proper function and alleviate discomfort.
Understanding Tenodesis
Tenodesis is the surgical suturing of a tendon’s end to a bone. This procedure involves reattaching a tendon securely to a new bony anchor point, often performed when a tendon has torn, detached, or requires repositioning for joint stability. The goal of tenodesis is to alleviate pain, restore strength, and improve the function of the affected joint by providing a stable attachment for the tendon.
Indications for Tenodesis
Tenodesis is performed when a tendon’s original attachment is compromised. Common indications include:
- A tear in the long head of the biceps tendon, particularly in the shoulder, which can result from overuse, trauma, or age-related degeneration.
- Chronic tendinopathy, where the tendon experiences persistent irritation and inflammation that has not responded to non-surgical treatments.
- Tendon instability, where the tendon repeatedly shifts out of its normal anatomical groove, causing pain and dysfunction.
- As part of a broader shoulder repair, such as addressing certain types of superior labrum anterior to posterior (SLAP) tears or rotator cuff tears, where the biceps tendon contributes to the overall stability of the joint.
This intervention is often favored in younger, more active individuals or athletes who require full restoration of strength and mobility.
The Surgical Approach
The tenodesis procedure can be performed using either an open surgical approach, which involves a single, larger incision, or through arthroscopic techniques, which utilize several small incisions. During an arthroscopic procedure, a tiny camera called an arthroscope is inserted to provide the surgeon with a clear view of the inside of the joint. Regardless of the approach, the general steps involve preparing the tendon end and the bone site for reattachment.
The damaged portion of the tendon is typically removed or detached from its original insertion point. A small hole or tunnel is then created in the bone, where the healthy portion of the tendon will be secured. The tendon is then anchored to the bone using specialized devices such as screws, anchors, or sutures, which are designed to provide a strong and lasting reattachment. This fixation allows for proper healing and integration of the tendon with the bone, aiming for a stable outcome.