All-suture anchors for distal biceps tendon repair: a preliminary outcome study

Introduction: The aim of this study was to retrospectively evaluate the clinical outcome of double intramedullary all-suture anchors’ fixation for distal biceps tendon ruptures. Materials and methods: A retrospective case series of patients who underwent primary distal biceps tendon repair with all-suture anchors was conducted. Functional outcome was assessed at a minimum follow-up of at 12 months based on the assessments of the Mayo Elbow Performance Score (MEPS), Andrews–Carson Score (ACS), Quick Disabilities of the Arm, Shoulder, and Hand questionnaire (QuickDASH), and the Visual Analog Scale (VAS) for pain. Maximum isometric strength test for flexion and supination as well as postoperative range of motion (ROM) were determined for both arms. Results: 23 patients treated with all-suture anchors were assessed at follow-up survey (mean age 56.5 ± 11.4 years, 96% male). The follow-up time was 20 months (range Q_0.25–Q_0.75, 15–23 months). The following outcome results were obtained: MEPS 100 (range Q_0.25–Q_0.75, 100–100); ACS 200 (range Q_0.25–Q_0.75, 195–200); QuickDASH 31 (range Q_0.25–Q_0.75, 30–31); VAS 0 (range Q_0.25–Q_0.75, 0–0). The mean strength compared to the uninjured side was 95.6% (range Q_0.25–Q_0.75, 80.9–104%) for flexion and 91.8 ± 11.6% for supination. There was no significant difference in ROM or strength compared to the uninjured side and no complications were observed in any patient. Conclusion: Distal biceps tendon refixation using all-suture anchors provides good-to-excellent results in terms of patient-reported and functional outcome. This repair technique appears to be a viable surgical option, although further long-term results are needed. Level of evidence: Level IV (case series).