Repair of acute and chronic distal biceps tendon ruptures using the EndoButton
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There are many ways to repair distal biceps tendon ruptures with no outcome studies demonstrating superiority of a specific technique. There are few studies reporting on the repair of acute and chronic distal biceps tendon ruptures using the EndoButton via an anterior single-incision approach. We report on 27 patients who underwent distal biceps tendon repair with an EndoButton. The average age was 50.1 years (range, 36–78). There were 17 acute repairs (within 4 weeks of injury), nine chronic repairs (greater than 4 weeks), and one revision of a previous acute repair. All chronic repairs were repaired without the need for graft augmentation. Patients were assessed postoperatively using the ASES elbow outcome instrument and isokinetic flexion and supination strength and endurance testing. Eight control subjects were also tested for comparison. At an average follow-up of 30.9 months, 26 of 27 patients returned to their previous employment and activity level. The average ASES elbow score was 98.2 (range, 81–100). Compared with the contralateral extremity, there was no loss of motion. Average flexion strength recovery was 101% and mean supination strength recovery was 99%. There was no significant difference in function or strength with repair of acute versus chronic ruptures. Using the EndoButton technique, acute and chronic distal biceps tendon ruptures can be repaired safely with excellent clinical results.
- Agins HJ, Chess JL, Hoekstra DV, et al. Rupture of the distal insertion of the biceps brachii tendon. Clin Orthop. 1988;234:34–8.
- Bain GI, Prem H, Heptinstall RJ, et al. Repair of distal biceps tendon rupture: a new technique using the EndoButton. J Shoulder Elbow Surg. 2000;9:120–6. CrossRef
- Bain GI. Repair of distal biceps tendon avulsion with the EndoButton technique. Tech Shoulder Elbow Surg. 2002;3:96–101. CrossRef
- Baker BE, Bierwagen D. Rupture of the distal tendon of the biceps brachii: operative versus non-operative treatment. J Bone Jt Surg. 1985;67-A:414–7.
- Boyd HB, Anderson LD. A method for reinsertion of the distal biceps brachii tendon. J Bone Jt Surg. 1961;43-A:1041–3.
- Chavan PR, Duquin TR, Bisson LJ. Repair of the ruptured distal biceps tendon: a systematic review. Am J Sports Med. 2008;36:1618–24. CrossRef
- D’Alessandro DF, Shields Jr CL, Tibone JE, et al. Repair of distal biceps tendon ruptures in athletes. Am J Sports Med. 1993;21:114–9. CrossRef
- Darlis NA, Sotereanos DG. Distal biceps tendon reconstruction in chronic ruptures. J Shoulder Elbow Surg. 2006;15:614–9. CrossRef
- Failla JM, Amadio PC, Morrey BF, et al. Proximal radioulnar synostosis after repair of distal biceps brachii rupture by the two-incision technique: a report of four cases. Clin Orthop. 1990;253:133–6.
- Gilchreest EL. The common syndrome of rupture, dislocation and elongation of the long head of the biceps brachii: an analysis of one hundred cases. Surg Gynecol Obstet. 1934;58:322–40.
- Greenberg JA, Fernandez JJ, Wang T, et al. EndoButton-assisted repair of distal biceps tendon ruptures. J Shoulder Elbow Surg. 2003;12:484–90. CrossRef
- Gregory T, Roure P, Fontes D. Repair of distal biceps tendon rupture using a suture anchor. Am J Sports Med. 2009;37(3):506–11. CrossRef
- Hallam P, Bain GI. Repair of chronic distal biceps tendon ruptures using autologous hamstring graft and the EndoButton. J Shoulder Elbow Surg. 2004;13:648–51. CrossRef
- Hang DW, Bach Jr BR, Bojchuk J. Repair of chronic distal biceps brachii tendon rupture using free autogenous semitendinosus tendon. Clin Orthop. 1996;323:188–91. CrossRef
- Idler CS, Montgomery WH, Lindsey DP, et al. Distal biceps tendon repair: a biomechanical comparison of intact tendon and 2 repair techniques. Am J Sports Med. 2006;34:968–74. CrossRef
- Kaplan FT, Rokito AS, Birdzell MG, et al. Reconstruction of chronic distal biceps tendon rupture with use of fascia lata combined with a ligament augmentation device: a report of 3 cases. J Shoulder Elbow Surg. 2002;11:633–6. CrossRef
- Kelly EW, Morrey BF, O’Driscoll SW. Complications of repair of the distal biceps tendon with the modified two-incision technique. J Bone Jt Surg. 2000;82-A:1575–81.
- Kettler M, Lunger J, Kuhn V, et al. Failure strengths in distal biceps tendon repair. Am J Sports Med. 2007;35:1544–8. CrossRef
- Kettler M, Tingart MJ, Lunger J, et al. Reattachment of the distal tendon of biceps: factors affecting the failure strength of the repair. J Bone Joint Surg Br. 2008;90:103–6. CrossRef
- King J, Bollier M. Repair of distal biceps tendon ruptures using the EndoButton. J Am Acad Orthop Surg. 2008;16:490–4.
- King GJW, Richards RR, Zuckerman JD, et al. A standardized method for assessment of elbow function. J Shoulder Elbow Surg. 1999;8:351–4. CrossRef
- Leighton MM, Bush-Jopseph CA, Bach Jr BR. Distal biceps brachii repair: results in dominant and nondominant extremities. Clin Orthop. 1995;317:114–21.
- Levy HJ, Mashoof AA, Morgan D. Repair of chronic ruptures of the distal biceps tendon using flexor carpi radialis tendon graft. Am J Sports Med. 2000;28:538–40.
- Limpisvasti O, Singer DI. Single-inicision suture anchor repair of distal biceps tendon rupture. Tech Hand Up Extrem Surg. 2003;7:82–6. CrossRef
- Linter S, Fischer T. Repair of distal biceps tendon using suture anchors and an anterior approach. Clin Orthop. 1996;322:116–9.
- Mazzocca AD, Burton KJ, Romero AA, et al. Biomechanical evaluation of 4 techniques of distal biceps brachii tendon repair. Am J Sports Med. 2007;35:252–8. CrossRef
- Morrey BF, Askew LJ, An KN, et al. Rupture of the distal tendon of the biceps brachii: a biomechanical study. J Bone Jt Surg. 1985;67-A:418–21.
- Peeters T, Ching-Soon NG, Jansen N, et al. Functional outcome after repair of distal biceps tendon ruptures using the EndoButton technique. J Shoulder Elbow Surg. 2009;18:283–7. CrossRef
- Ramsey ML. Distal biceps tendon injures: diagnosis and management. J Am Acad Orthop Surg. 1999;7:199–207.
- Ranelle RG. Use of the EndoButton in repair of the distal biceps brachii tendon. Proc (Baylor Univ Med Cent). 2007;20:235–6.
- Rantanen J, Orava S. Rupture of the distal biceps tendon: a report of 19 patients treated with anatomic reinsertion, and a meta-analysis of 147 cases found in the literature. Am J Sports Med. 1999;27:128–32.
- Sanchez-Sotelo J, Morrey BF, Adams RA, et al. Reconstruction of chronic ruptures of the distal biceps tendon with use of an Achilles tendon allograft. J Bone Jt Surg. 2002;84-A:999–1005.
- Sotereanos DG, Pierce TD, Varitimidis SE. A simplified method for repair of distal biceps tendon ruptures. J Shoulder Elbow Surg. 2000;9:227–33. CrossRef
- Sprang JT, Weinhold PS, Karas SG. A biomechanical comparison of EndoButton versus suture anchor repair of distal biceps tendon injuries. J Shoulder Elbow Surg. 2006;15:509–14. CrossRef
- Wiley WB, Noble JS, Dulaney TD, et al. Late reconstruction of chronic distal biceps tendon ruptures with a seitendinosis autograft technique. J Shoulder Elbow Surg. 2006;15:440–4. CrossRef
- Repair of acute and chronic distal biceps tendon ruptures using the EndoButton
Volume 6, Issue 1 , pp 39-46
- Cover Date
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- Distal biceps tendon ruptures
- Single incision
- Industry Sectors
- Author Affiliations
- 1. Department of Orthopedic Surgery, The Permanente Medical Group, 2025 Morse Avenue, Sacramento, CA, 95825, USA
- 2. Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, 200 Hawkins Dr, 01008 JPP, Iowa City, IA, 52242, USA
- 3. Healthcare Midwest Hand and Elbow Surgery, Michigan State University College of Human Medicine, 601 John Street, Suite M-230, Kalamazoo, MI, 49008, USA