title: Distal biceps tendon repair: a cadaveric analysis of suture anchor and interference screw restoration of the anatomic footprint.
abstract: BACKGROUND
  Distal biceps tendon repair with interference screw or double suture-anchor fixation are 2 successful techniques performed with either 1- or 2-incision approaches. No study has examined the accuracy and quality of the repaired tendon footprint with these devices and approaches.
  
  
  OBJECTIVE
  A 2-incision approach will allow a more anatomic repair of the distal biceps footprint compared with a 1-incision anterior approach. Fixation technique will affect insertional footprint location and footprint contact area.
  
  
  METHODS
  Controlled laboratory study.
  
  
  METHODS
  After randomization, 36 distal biceps repairs were performed on human cadaveric upper extremity specimens, with 1- or 2-incision approaches and with fixation devices of either two 5.5-mm suture anchors or an 8-mm interference screw. Native and repaired footprint areas and centroid location were calculated with a 3-dimensional digitizer.
  
  
  RESULTS
  Interference screw repair had the smallest footprint area (135 mm(2)) compared with suture anchor repair (197 mm(2)) and the native tendon (259 mm(2)) (P = .013). The 2-incision approach repaired the footprint to a more posterior and anatomic position (2.5 mm) than a 1-incision approach (P = .001). The fixation device did not affect footprint location significantly.
  
  
  CONCLUSIONS
  Suture anchor repair more closely re-creates the footprint area on the radial tuberosity of the native distal biceps tendon compared with the interference screw repair. A 2-incision approach more closely re-creates footprint position compared with the 1-incision approach.
  
  
  CONCLUSIONS
  A 2-incision approach with double suture-anchor fixation may yield a more anatomic distal biceps repair based on reproduction of the footprint compared with a 1-incision approach.
authors.affiliation: Center for Shoulder, Elbow, and Sports Medicine, Department of Orthopedic Surgery, Columbia University, New York, New York, USA.
authors.forename: Charles M
authors.initials: CM
authors.lastname: Jobin
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Kippe
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Gardner
authors.forename: William N
authors.initials: WN
authors.lastname: Levine
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Ahmad
mesh_terms: D000368:Aged; D001132:Arm / Q000033:anatomy & histology / Q000601:surgery; D001134:Arm Injuries / Q000601:surgery*; D001863:Bone Screws; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000033:anatomy & histology / Q000601:surgery; D011897:Random Allocation; D013536:Suture Techniques; D013708:Tendon Injuries / Q000601:surgery*