Retrospective Study of the Distal Biceps Tendon Repair Using "All-suture" Soft Anchors

Introduction: Distal biceps repair is commonly performed using various fixation devices, each having its advantages and drawbacks. All-suture soft anchor (ASSA) is a recent device mitigating some of the issues associated with previous devices. Materials and Methods: This retrospective study including 20 patients (21 ruptures) aims to evaluate the safety and functionality of ASSA by modified tension-slide technique. All operations were performed through a single-incision anterior approach using two 2.9 mm anchors. All but 1 were men with a mean age of 50.5 years. The mean duration from injury to surgery was 14 days. Results: At a mean follow-up of 11.8 months, compared with contralateral extremity, 18 (86%) of 21 regained full biceps strength with 5/5 flexion-supination power, while 3 displayed 4/5 power. All, except 1, returned to the previous level of function at an average of 24 weeks. As per the modified Mayo Elbow Performance Index, 18 (86%) achieved excellent and 3 (14%) had good results. Complications included lateral antebrachial cutaneous nerve palsy in 12 (resolved in 10), superficial radial nerve palsy in 1 (resolved), and heterotopic ossification in 1. No device-related complications or reruptures were noted. Conclusion: Primary repair of distal biceps tendon ruptures through the use of the ASSA is a viable option, which in conjunction with the proposed modification of tension-slide suture fixation technique yields clinically objective and functional results. Level of Evidence: Level IV - therapeutic.