The primary symptom of tenodesis failure, especially concerning a failed biceps tenodesis, is often persistent pain in the area of the bicipital groove. This pain can stem from the mechanical breakdown of the tenodesis itself or from other underlying shoulder issues that were not resolved during the initial surgery.
Tenodesis is a surgical procedure that involves reattaching a tendon to bone, commonly performed for conditions like biceps tendonitis or tears. When this procedure fails, it can lead to a recurrence of symptoms or new discomfort.
Key Symptoms of Failed Tenodesis
Recognizing the signs of tenodesis failure is crucial for proper diagnosis and subsequent treatment. While persistent pain is a hallmark, several other indicators can point to a failed procedure.
1. Persistent Bicipital Groove Pain
- Description: This is the most common and often the earliest sign of a failed biceps tenodesis. The pain is typically localized to the front of the shoulder, specifically in the groove where the biceps tendon normally rests.
- Characteristics: The pain can range from a dull ache to sharp, intense discomfort, often worsening with activity, lifting, or specific arm movements. It may persist even after the typical recovery period for the initial surgery.
2. Recurrent Weakness
- Description: Patients may experience a noticeable decrease in strength, particularly during activities that involve bending the elbow (flexion) or rotating the forearm (supination).
- Impact: This weakness can affect daily tasks, sports performance, and overall arm function.
3. Muscle Cramping
- Description: Unexplained cramping in the biceps muscle can occur, especially during or after activity. This is due to the muscle struggling to function properly without its stable attachment.
- Sensation: Patients might describe a feeling of the muscle "balling up" or tightening painfully.
4. Visible Deformity (Popeye Sign)
- Description: If the biceps tendon completely detaches after a failed tenodesis, it can retract down the arm, creating a noticeable bulge in the lower part of the upper arm. This is commonly referred to as a "Popeye deformity."
- Appearance: This bulge becomes more prominent when the muscle contracts. While some patients may not experience significant pain with this deformity, it clearly indicates a mechanical failure of the tenodesis.
5. Clicking, Popping, or Grinding Sensations
- Description: Patients might hear or feel audible clicks, pops, or grinding in the shoulder during movement. This can indicate instability or friction within the joint, potentially due to the detached tendon or other unaddressed issues.
- Association: These sensations are often accompanied by pain.
Symptom Overview Table
| Symptom | Description | Common Cause in Failure |
|---|---|---|
| Persistent Pain | Localized pain in the front of the shoulder, specifically the bicipital groove, often worsening with activity. | Mechanical failure of the tenodesis, unaddressed pathology. |
| Recurrent Weakness | Difficulty with elbow flexion and forearm supination, leading to reduced strength. | Inadequate tendon stability or reattachment. |
| Muscle Cramping | Involuntary, painful contractions of the biceps muscle, especially during or after activity. | Functional impairment due to improper tendon anchoring. |
| Visible Deformity | A bulge in the lower part of the upper arm ("Popeye sign") when the biceps contracts. | Complete detachment and retraction of the biceps tendon. |
| Clicking/Popping Sensations | Audible or palpable sounds within the shoulder joint during movement. | Instability, friction, or tendon snapping. |
When to Seek Medical Attention
If you have undergone a tenodesis procedure and experience any of these symptoms, it is essential to consult an orthopedic surgeon. Early diagnosis of a failed tenodesis can help determine the best course of action, which may include non-surgical management or revision surgery. A healthcare professional can perform a thorough examination, order imaging studies like MRI, and assess the underlying cause of your symptoms.
[Orthopedic Health]
