This study seeks to determine the outcome following acute distal biceps tenodesis utilizing an anterior incision, suture anchor fixation and precise, early rehabilitation.

Materials and Methods:

Twenty patients (average age 46) and 11 dominant extremities were operated. Outcome was assessed at least one year after surgery using the DASH questionnaire, a directed H/P examination, strength testing (BTE), and flourosopic imaging. Fifteen patients had pre-operative BTE measurements and in 14, post-operative strength recovery was measured at four and six months. Seven patients completed DASH questionnaires prior to surgery and in conjunction with strength measurements.

Results:

All patients were satisfied with their outcome. Satisfaction clearly increased as their strength measurements improved. At one year or greater, in both dominant and non-dominant extremities, average supination (average -3%, range –31% to +26%) and flexion (average +4%, range –4% to +18%) strength were not significantly different than in the uninjured upper extremity. Full motion was obtained within 6-8 weeks. The presence of degenerative joint disease did not significantly affect the final result. Transient neuropraxic injury to the lateral antebrachial cutaneous nerve occurred in five patients and to the median nerve in one patient with severe diabetes. Though very small amounts of heterotopic bone were noted in several patients this did not affect motion.

Conclusion:

In the properly selected patient, anatomic re-insertion of the ruptured distal biceps tendon through a single anterior incision followed by precise early rehabilitation is both safe and effective. Outcome is equivalent to that following tenodesis using a two incision technique and far surpasses nonoperative treatment results.