Repair of distal biceps tendon rupture using a suture anchor: description of a new endoscopic procedure

Abstract

Background: Repair of a distal biceps tendon rupture is a challenging procedure and, to date, there is no consensus as to which technique should be used because of the specific complications reported for each.

Purpose: A new endoscopic technique is described that uses a suture anchor to repair distal biceps tendon ruptures.

Study design: Case series; Level of evidence, 4.

Methods: The results of a cohort of 23 patients (25 elbows) are reported with a median follow-up of 26 months. All patients were male and their median age was 44 years (range, 30-58). Ten of the patients (12 ruptures) were professional athletes or had a high level of physical activity. All repairs were performed via a 3-cm incision made in the "safe area" of the anterior crease of the forearm. The whole procedure was performed within the tendon sheath. The tendon was reinserted using a single anchor.

Results: Of the 23 patients, 22 were satisfied and 20 patients returned to their preinjury sports and jobs. There was a mean loss of 8.6 degrees of pronation and 5 degrees of supination. A single severe neurologic complication, which required a second surgical procedure, was reported. There were also 2 ectopic ossifications without clinical consequences and a transitory radial nerve paralysis.

Conclusions: This study clearly demonstrated that endoscopic repair of the ruptured distal biceps tendon is safe, effective, and reproducible. It provides good functional outcome and early recovery with few complications. Postoperative median nerve palsy due to edema is a possible concern for patients involved in athletic activity and with a history of nerve entrapment; thus this technique should be used with caution in this group of patients.