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Surgical repair of the distal biceps brachii tendon: a comparative study of three surgical fixation techniques

  • Elbow
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Several fixation techniques exist to repair the distal biceps brachii tendon. We aimed to evaluate the clinical and functional outcomes after distal biceps tendon repair using three different fixation techniques.

Methods

A total of 54 patients were included in the study and were available for follow-up (mean, 30.7 months; SD 18.6). Surgery was performed using a single-incision approach with Corkscrews or Mitek suture anchors or with a two-incision exposure using transosseous sutures. The patients were evaluated with range of motion (ROM) measurements for flection/extension and pronation/supination as well as Disabilities of Arm Shoulder and Hand (DASH) scores. Furthermore, the duration of surgery and the length of hospital stay as well as the complication rate were analyzed.

Results

Fifty-four out of 73 patients were available after a mean follow-up time of 30.7 months (SD 18.6) for clinical evaluation. There was no statistical significant difference between the three groups comparing the mean DASH score, the length of hospital stay, the duration of surgery, or the ROM. The most common complication was neurapraxia, with 6 cases. All 3 reruptures were registered in the Mitek anchors group. Two patients in the Mitek anchors group required an open arthrolysis due to stiffness of the elbow.

Conclusions

In summary, we achieved good clinical and functional results after surgical repair of the distal biceps tendon using Corkscrews, Mitek anchors, or transosseous sutures. The results conferred by Corkscrews were comparable to the other techniques, justifying their use.

Level of evidence

III.

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References

  1. Bain GI, Prem H, Heptinstall RJ, Verhellen R et al (2000) Repair of distal biceps tendon rupture: a new technique using the Endobutton. J Shoulder Elbow Surg 9:120–126

    Article  PubMed  CAS  Google Scholar 

  2. Baker BE, Bierwagen D (1985) Rupture of the distal tendon of the biceps brachii. Operative versus non-operative treatment. J Bone Joint Surg Am 67:414–417

    PubMed  CAS  Google Scholar 

  3. Barber FA, Hapa O, Bynum JA (2010) Comparative testing by cyclic loading of rotator cuff suture anchors containing multiple high-strength sutures. Arthroscopy 26:S134–S141

    Article  PubMed  Google Scholar 

  4. Beaton DE, Katz JN, Fossel AH, Wright JG et al (2001) Measuring the whole or the parts? Validity, reliability, and responsiveness of the Disabilities of the Arm, Shoulder and Hand outcome measure in different regions of the upper extremity. J Hand Ther 14:128–146

    PubMed  CAS  Google Scholar 

  5. Bisson L, Moyer M, Lanighan K, Marzo J (2008) Complications associated with repair of a distal biceps rupture using the modified two-incision technique. J Shoulder Elbow Surg 17:67S–71S

    Article  PubMed  Google Scholar 

  6. Boyd H, Anderson L (1961) A method for reinsertion of the distal biceps brachii tendon. J Bone Joint Surg Am 43:1041–1043

    Google Scholar 

  7. Chavan PR, Duquin TR, Bisson LJ (2008) Repair of the ruptured distal biceps tendon: a systematic review. Am J Sports Med 36:1618–1624

    Article  PubMed  Google Scholar 

  8. Chillemi C, Marinelli M, De Cupis V (2007) Rupture of the distal biceps brachii tendon: conservative treatment versus anatomic reinsertion–clinical and radiological evaluation after 2 years. Arch Orthop Trauma Surg 127:705–708

    Article  PubMed  Google Scholar 

  9. Cummins CA, Strickland S, Appleyard RC, Szomor ZL et al (2003) Rotator cuff repair with bioabsorbable screws: an in vivo and ex vivo investigation. Arthroscopy 19:239–248

    Article  PubMed  Google Scholar 

  10. De Carli A, Zanzotto E, Vadala AP, Luzon D et al (2009) Surgical repair of the distal biceps brachii tendon: clinical and isokinetic long-term follow-up. Knee Surg Sports Traumatol Arthrosc 17:850–856

    Article  PubMed  Google Scholar 

  11. Dobbie R (1941) Avulsion of the lower biceps brachii tendon. Analysis of fifty-one previously reported cases. Am J Surg 51:662–683

    Article  Google Scholar 

  12. El-Hawary R, Macdermid JC, Faber KJ, Patterson SD et al (2003) Distal biceps tendon repair: comparison of surgical techniques. J Hand Surg Am 28:496–502

    Article  PubMed  Google Scholar 

  13. Freeman CR, McCormick KR, Mahoney D, Baratz M et al (2009) Nonoperative treatment of distal biceps tendon ruptures compared with a historical control group. J Bone Joint Surg Am 91:2329–2334

    Article  PubMed  Google Scholar 

  14. Golish SR, Caldwell PE 3rd, Miller MD, Singanamala N et al (2008) Interference screw versus suture anchor fixation for subpectoral tenodesis of the proximal biceps tendon: a cadaveric study. Arthroscopy 24:1103–1108

    Article  PubMed  Google Scholar 

  15. Hunsaker FG, Cioffi DA, Amadio PC, Wright JG et al. (2002) The American academy of orthopaedic surgeons outcomes instruments: normative values from the general population. J Bone Joint Surg Am 84-A:208–215

    Google Scholar 

  16. Johnson TS, Johnson DC, Shindle MK, Allen AA et al (2008) One- versus two-incision technique for distal biceps tendon repair. HSS J 4:117–122

    Article  PubMed  Google Scholar 

  17. Kelly EW, Morrey BF, O’Driscoll SW (2000) Complications of repair of the distal biceps tendon with the modified two-incision technique. J Bone Joint Surg Am 82-A:1575–1581

    Google Scholar 

  18. Khan AD, Penna S, Yin Q, Sinopidis C et al (2008) Repair of distal biceps tendon ruptures using suture anchors through a single anterior incision. Arthroscopy 24:39–45

    Article  PubMed  Google Scholar 

  19. Krushinski EM, Brown JA, Murthi AM (2007) Distal biceps tendon rupture: biomechanical analysis of repair strength of the Bio-Tenodesis screw versus suture anchors. J Shoulder Elbow Surg 16:218–223

    Article  PubMed  Google Scholar 

  20. Leighton MM, Bush-Joseph CA, Bach BR Jr (1995) Distal biceps brachii repair. Results in dominant and nondominant extremities. Clin Orthop Relat Res 317:114–121

    PubMed  Google Scholar 

  21. Lemos SE, Ebramzedeh E, Kvitne RS (2004) A new technique: in vitro suture anchor fixation has superior yield strength to bone tunnel fixation for distal biceps tendon repair. Am J Sports Med 32:406–410

    Article  PubMed  Google Scholar 

  22. Lorbach O, Bachelier F, Vees J, Kohn D et al (2008) Cyclic loading of rotator cuff reconstructions: single-row repair with modified suture configurations versus double-row repair. Am J Sports Med 36:1504–1510

    Article  PubMed  Google Scholar 

  23. McKee MD, Hirji R, Schemitsch EH, Wild LM et al (2005) Patient-oriented functional outcome after repair of distal biceps tendon ruptures using a single-incision technique. J Shoulder Elbow Surg 14:302–306

    Article  PubMed  Google Scholar 

  24. Pauly S, Kieser B, Schill A, Gerhardt C et al (2010) Biomechanical comparison of 4 double-row suture-bridging rotator cuff repair techniques using different medial-row configurations. Arthroscopy 26:1281–1288

    Article  PubMed  Google Scholar 

  25. Ryhanen J, Kaarela O, Siira P, Kujala S et al (2006) Recovery of muscle strength after late repair of distal biceps brachii tendon. Scand J Surg 95:68–72

    PubMed  CAS  Google Scholar 

  26. Safran MR, Graham SM (2002) Distal biceps tendon ruptures: incidence, demographics, and the effect of smoking. Clin Orthop Relat Res 404:275–283

    Article  PubMed  Google Scholar 

  27. Sutton KM, Dodds SD, Ahmad CS, Sethi PM (2010) Surgical treatment of distal biceps rupture. J Am Acad Orthop Surg 18:139–148

    PubMed  Google Scholar 

  28. Weinstein DM, Ciccone WJ 2nd, Buckler MC, Balthrop PM et al (2008) Elbow function after repair of the distal biceps brachii tendon with a two-incision approach. J Shoulder Elbow Surg 17:82S–86S

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany

    Mustafa Citak, Manuel Backhaus, Dominik Seybold, Thomas A. Schildhauer & Bernd Roetman

  2. Department of Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY, USA

    Eduardo M. Suero

Authors
  1. Mustafa Citak
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  2. Manuel Backhaus
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  3. Dominik Seybold
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  4. Eduardo M. Suero
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  5. Thomas A. Schildhauer
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  6. Bernd Roetman
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Correspondence to Mustafa Citak.

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Citak, M., Backhaus, M., Seybold, D. et al. Surgical repair of the distal biceps brachii tendon: a comparative study of three surgical fixation techniques. Knee Surg Sports Traumatol Arthrosc 19, 1936–1941 (2011). https://doi.org/10.1007/s00167-011-1591-0

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  • DOI: https://doi.org/10.1007/s00167-011-1591-0

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