Failure strengths in distal biceps tendon repair.
BACKGROUND
Surgical repair is the most favored treatment for a rupture of the distal biceps tendon. A variety of techniques have been described for distal biceps tendon reattachment, including transosseous sutures, suture anchors, interference screws, and an EndoButton-based technique.


OBJECTIVE
EndoButton and suture anchor have initially stronger fixation strengths than do transosseous sutures, allowing early postoperative rehabilitation.


METHODS
Controlled laboratory study.


METHODS
Single loads to failure and mode of failure of 13 different fixation techniques were determined using 130 human cadaveric elbows. Quantitative computer tomography was performed to exclude differences in bone mineral density as an affecting factor. Repeated-measures analysis of variance was used to assess differences in failure load between repair techniques.


RESULTS
The EndoButton-based technique showed a significantly higher failure load (259 +/- 28 N) than did all other techniques (P < .05). No significant differences were seen between the transosseous suture technique (210 +/- 29 N) and most other techniques (P > .05). Failure loads of the TwinFix-QuickT (57 +/- 29 N) and Biocuff screw (105 +/- 28 N) were significantly lower than those of all other repairs (P < .05).


CONCLUSIONS
Significant differences exist in failure loads and modes of failure for the different repair techniques after rupture of the distal biceps tendon.


CONCLUSIONS
The transosseous technique is still a sufficient and cost-saving procedure for repair of the distal biceps tendon. TwinFix-QuickT 5.0 mm and Biocuff screw 5.7 mm had significantly lower failure loads, which might affect early rehabilitation, particularly in patients with poor bone quality.
Kettler
Mark
M
University Hospital of Munich, Department of Surgery, Innenstadt, Munich, Germany. mark.kettler@gmx.de
Lunger
Josef
J
Kuhn
Volker
V
Mutschler
Wulf
W
Tingart
Markus J
MJ
D000368:Aged; D001134:Arm Injuries / Q000503:physiopathology* / Q000601:surgery*; D015519:Bone Density; D002102:Cadaver; D005260:Female; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D012421:Rupture / Q000503:physiopathology / Q000601:surgery; D013708:Tendon Injuries / Q000503:physiopathology* / Q000601:surgery*; D013718:Tensile Strength; D016896:Treatment Outcome