Failure of the Interference Tenodesis Screw After Distal Bicep Tendon Repair With a Suture Button Technique: A Report of Two Cases

Abstract

Distal bicep tendon rupture is an uncommon form of bicep rupture which is typically seen in middle-aged men. We identified two cases in which the distal bicep tendon rupture was repaired with an EndoButton™ (Smith and Nephew, Watford, UK) and interference screw with preservation of the EndoButton™​ but a failure of the interference screw. This report highlights the addition of a FiberWire ® (Arthrex, Inc., Naples, Florida, USA) construct to secure the interference screw from backing out and emphasizes the EndoButton™ as the primary biomechanical anchor in maintaining a successful distal bicep tendon repair. We question the necessity of both the interference screw and EndoButton™ in the fixation of the distal bicep tendon and recommend that securing the interference tenodesis screw with an additional FiberWire ® may provide a more secure fixation of the screw as compared to traditional approaches.

Advanced strategies for constructing interfacial tissues of bone and tendon/ligament

“… 11 – 13 This is achieved through: (a) direct insertion of the broken enthesis into the bone tunnel, (b) mechanical anchoring of the reconstructed tissue using sutures or screws, and (c) minimizing externally-loaded forces to avoid accidental loosening or re-rupture after surgery. 14 – 19 Because traditional surgical treatments mainly focus on reestablishing enthesis anatomy while overlooking enthesis tissue regeneration, their efficacy in enthesis repair is limited. For instance, the reestablished enthesis may remain weakly connected to the bone for an extended time, leading to the formation of scar tissue instead of the desired healthy enthesis tissue, and in severe cases degeneration and lysis may occur, resulting in the loss of the anatomical reconnection between the enthesis and the bone.…”