Fixation of Acute Distal Biceps Tendon Ruptures Using Mitek Anchors: A Retrospective Study

Abstract

Purpose of this Study:The aim of this study was to evaluate the outcomes of surgical intra-osseous fixation of the distal tendon of the ruptured biceps brachii muscle using Mitek anchors.Materials and Methods:Between 2005 and 2011, seven patients underwent unilateral distal biceps tendon repair using Mitek anchors. All patients were men aged between 36 and 47 years. Six patients were assessed by physical examination and use of the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire.Results:Surgery was performed within 3 to 17 days of rupture with a mean follow-up of 35 months. Of the six fully completed DASH questionnaires, three patients had a score of 0, and three patients had scores of 5.8, 10 and 10.8, respectively (10.1 is the mean score for the general population). Transient paraesthesias in the lateral antebrachial cutaneous nerve region occurred in two patients and one patient experienced a transient stiffness of the elbow due to scarring of the wound. No major complicatons have occurred.Conclusion:The use of Mitek anchors for the re-insertion of the ruptured distal biceps tendon proved to be a safe and effective technique with excellent functional results in our series.

Single Incision Distal Biceps Repair With Hemi-Krackow Suture Technique

“…Our present study shows that clinical outcomes are comparable to those reported previously in the literature 1,7,9,17,19,24 (see Table 2). All patients regained full elbow range of motion at an average of 5.4 months and demonstrated satisfactory functionality with an average QuickDASH score of 6.5.…”

Distal biceps tendon repair using both an anchor and a bone tunnel via one and a second stab incision: A retrospective study

“…Studies have been conducted regarding the best treatment of distal biceps tendon rupture, such as the use of one or two incisions, 4 anatomic or nonanatomic restoration of the ruptured tendon, and the kind of materials that should be used. 11,[13][14][15][16] Research is focused on measuring parameters in cadavers, usually the load to failure. Our study was conducted in humans, making it impossible to measure the load to failure.…”

“…While in some studies Endobutton-type devices seem to provide stronger initial repair, 10 suture anchor techniques-in most studies-present inferior biomechanical properties. 13,14 On the other hand, interference screws alone seem to be weaker than other techniques but, apparently, they recreate native load and stiffness. 15,17 More recently, the use of hybrid fixation, such as the fixation with both a button-type device and an interference screw, has given some promising results regarding the initial fixation strength and the gap formation.…”

“…The diagnosis of the distal biceps tendon rupture was made according to the clinical findings (palpation, hook test, Popeye sign) along with the Magnetic Resonance Imaging (MRI) findings in all patients who met the inclusion criteria (hematoma, complete detachment of the insertional tendon, retraction of the proximal stump). [8][9][10][11][12][13][14][15][16][17][18][19] All ruptures were acute at the time of surgical intervention-3 weeks at maximum-and they all involved the dominant upper limb. All patients returned for clinical examination, radiographic evaluation, and functional measurements using Cybex ergometer (http://www.cybexintl.com/company/overview/ heritage.aspx).…”

The utility of ultrasound in showing a unique cause of posterior interosseous nerve syndrome

“…(E) Lateral and AP Xray views of the right forearm and 2 biceps anchors with distal anchor appearing to protrude through posterior aspect of radius (arrow head). (F) Schematic depiction of biceps tendon anchors, with anchor morphology shown in the top right corner [4] . …”