title: A comparison of cortical button with interference screw versus suture anchor techniques for distal biceps brachii tendon repairs.
abstract: BACKGROUND
  Distal biceps brachii tendon repairs performed by a "tension slide technique" with a cortical button and interference screw (CB) are stronger than repairs by suture anchor (SA) techniques in biomechanical studies. However, clinical comparison of the 2 techniques is lacking in the literature.
  
  
  METHODS
  Distal biceps tendon ruptures repaired with either a CB or SA technique through a single incision were identified from 2008 to 2013 at a single institution. Patients more than a year out from surgery completed a Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. In addition, patients were assessed for range of motion, strength, and complications. All assessments were performed by individuals blinded to the surgical technique. Strength and motion values from the operative extremity minus the nonoperative arm values yielded differential values that were averaged and used to compare treatment groups.
  
  
  RESULTS
  The CB (n = 20) and SA (n = 17) groups had similar demographics, except for the time from the surgery to evaluation (18 ± 5 vs 32 ± 15 months, respectively; P = .007). Range of motion differed slightly between the groups. The CB group demonstrated better pronation (0° ± 5° vs -4° ± 10°; P < .05), and the SA group demonstrated better flexion (2° ± 0° vs -3° ± 5°; P < .05) and supination (-2° ± 5° vs -7° ± 12°; P < .05). Strength did not differ significantly between the groups. DASH scores did not significantly differ between the groups with univariate analysis, but multivariate analysis demonstrated slightly better DASH scores with the CB technique (4.5 ± 4.4 vs 10.3 ± 14.9; P < .0009). Complication rates were similar between groups (CB 30%, SA 35%; P > .05).
  
  
  CONCLUSIONS
  CB and SA techniques provide good clinical results with similar complication rates.
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, NY, USA.
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Olsen
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, NY, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Shields
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, NY, USA.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Williams
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, NY, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Miller
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, NY, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Maloney
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, NY, USA. Electronic address: Ilya_Voloshin@urmc.rochester.edu.
authors.forename: Ilya
authors.initials: I
authors.lastname: Voloshin
mesh_terms: D000328:Adult; D000368:Aged; D001134:Arm Injuries / Q000601:surgery*; D001863:Bone Screws; D004550:Elbow / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D053441:Suture Anchors; D013536:Suture Techniques; D013708:Tendon Injuries / Q000601:surgery*
keywords: Distal biceps brachii tendon repair; cortical button; interference screw; suture anchor