Abstract
Background
Distal biceps tendon ruptures are uncommon injuries with only around 300 cases reported in the literature. Current management tends to favour anatomical reinsertion of the tendon into the radial tuberosity, especially in young and active individuals. These injuries are commonly repaired using either a single anterior incision with suture anchors or the Boyd-Anderson dual incision technique.
Case report
We report the use of a bioabsorbable interference screw for the repair of distal biceps tendon rupture using a minimal incision technique. In this technique the avulsed tendon and a bioabsorbable screw are secured in a drill hole on the radial tuberosity using whip stitch and fibre wire sutures according to Biotenodesis system guidelines.
Conclusion
The technique described requires minimal volar dissection that is associated with a reduced number of synostosis and posterior interosseous nerve injuries. The bioabsorbable interference screw has all the advantages of being biodegradable and has been shown to have greater pullout strength than suture anchors. It is also a reasonable alternative to titanium screws in terms of primary fixation strength. The strong fixation provided allows early active motion and return to previous activities as seen in our case.
Similar content being viewed by others
References
Aldridge JW, Bruno RJ, Straunch RJ, Rosenwasser MP (2000) Management of acute and chronic biceps tendon rupture. Hand Clin 16:497–503
Barber FA, Deck MA (1995) The in vivo histology of an absorbable suture anchor: a preliminary report. Arthroscopy 11:77–81
Berlet GC, Johnson JA, Milne AD, Patterson SD, King GJ (1998) Distal biceps brachii tendon repair. An in vitro biochemical study of tendon reattachment. Am J Sports Med 26:428–432
Bernstein AD, Breslow MJ, Jazravi LM (2001) Distal biceps tendon ruptures: a historical perspective and current concepts. Am J Orthop 30:193–200
Boileau P, Krishnan SG, Coste JS, Walch G (2002) Arthroscopic biceps tenodesis: a new technique using bioabsorbable interference screw fixation. Arthroscopy 18:1002–1012
Boyd HB, Anderson LD (1961) A method for reinsertion of the distal biceps brachii tendon. J Bone Joint Surg Am 43:1041–1043
D’Arco P, Sitler M, Kelly J, Moyer R, Marchetto P, Kimura I, Ryan J (1998) Clinical, functional, and radiographic assessments of the conventional and modified Boyd-Anderson surgical procedures for repair of distal biceps tendon ruptures. Am J Sports Med 26:254–261
Lajtai G, Noszian I, Humer K, Unger F, Aitzetmuller G, Orthner E (1999) Serial magnetic resonance imaging evaluation of operative site after fixation of patellar tendon graft with bioabsorbable interference screws in anterior cruciate ligament reconstruction. Arthroscopy 15:709–718
Lintner S, Fischer T (1996) Repair of distal biceps tendon using suture anchors and an anterior approach. Clin Orthop 322:116–119
McReynolds IS (1963) Avulsion of the insertion of the biceps brachii tendon and its surgical treatment. J Bone Joint Surg Am 45:1780–1781
Morgan CD, Gehrmann RM, Jayo MJ, Johnson CS (2002) Histological findings with a bioabsorbable anterior cruciate ligament interference screw explant after 2.5 years in vivo. Arthroscopy 18:E47
Morrey BF, Askew LJ, An KN, Dobyns JH (1985) Rupture of the distal tendon of the biceps brachii. A biomechanical study. J Bone Joint Surg Am 67:418–421
Morrison KD, Hunt TR 3rd (2002) Comparing and contrasting methods for tenodesis of the ruptured distal biceps tendon. Hand Clin 18:169–178
Norman WH (1985) Repair of avulsion of insertion of biceps brachii tendon. Clin Orthop 193:189–194
Pereira DS, Kvitne RS, Liang M, Giacobetti FB, Ebramzadeh E (2002) Surgical repair of distal biceps tendon ruptures: a biomechanical comparison of two techniques. Am J Sports Med 30:432–436
Ramsey ML (1999) Distal biceps tendon injuries: diagnosis and management. J Am Acad Orthop Surg 7:199–207
Rantenen J, Orava S (1999) Rupture of the distal biceps tendon. A report of nineteen patients treated with anatomic reinsertion, and a meta-analysis of 147 cases found in literature. Am J Sports Med 27:128–132
Rupp S, Krauss PW, Fritsch EW (1997) Fixation strength of a biodegradable interference screw and a press-fit technique in anterior cruciate ligament reconstruction with a BPTB graft. Arthroscopy 13:61–65
Rupp S, Seil R, Schneider A, Kohn DM (1999) Ligament graft initial fixation strength using biodegradable interference screws. J Biomed Mater Res 48:70–74
Sotereanos DG, Pierce TD, Varitimidis SE (2000) A simplified method of repair for distal biceps tendon ruptures. J Shoulder Elbow Surg 9:227–233
Straunch RJ (2001) Techniques of distal biceps tendon repair. Curr Opin Orthop 12:338–342
Strauch RJ, Michelson H, Rosenwasser MP (1997) Repair of rupture of the distal tendon of the biceps brachii. Review of literature and report of three cases treated with a single anterior incision and suture anchors. Am J Orthop 26:151–156
Szymankiewickz J, Ramesh FT, Bunker T (2003) Biotenodesis post: a novel technique for knotless arthroscopic cuff repair. British Elbow and Shoulder Society, 14th Annual Scientific Meeting, May 2003
Verhaven E, Huylebroek J, Van Nieuwenhuysen W, Van Overschelde J (1993) Surgical treatment of acute biceps tendon ruptures with a suture anchor. Acta Orthop Belg 59:426–429
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Khan, W., Agarwal, M. & Funk, L. Repair of distal biceps tendon rupture with the Biotenodesis screw. Arch Orthop Trauma Surg 124, 206–208 (2004). https://doi.org/10.1007/s00402-004-0639-8
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00402-004-0639-8