It is very important that a ruptured biceps tendon, or an avulsion be repaired as quickly as possible because studies have shown that if the injury is more than three to four weeks old, surgery may not be successful. The surgeon makes an incision at the site of the tendon and anchors the tendon back.
If the injury is older, it may be more difficult to retrieve the tendon and anchor it, so the surgeon will likely have to make a second incision to reach it. As well, the surgeon may have to graft or add a tendon alongside the biceps tendon to add strength.