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.

This is a pre-copyedited, author-produced version of an article accepted for publication in Techniques in Orthopaedics. The published version of record [Retrospective Study of the Distal Biceps Tendon Repair Using “All-suture” Soft Anchors. Techniques in Orthopaedics 37, 3 p142-148 (2022)] is available online at: 10.1097/BTO.0000000000000555.



Work Title Retrospective Study of the Distal Biceps Tendon Repair Using "All-suture" Soft Anchors
Open Access
  1. Sreenivasulu Metikala
  2. Zena Saleh
  3. Dov A. Bader
  4. Wayne J. Sebastianelli
  5. Paul S. Sherbondy
  1. Distal biceps rupture
  2. Single anterior incision
  3. All-suture anchor
  4. Soft anchor
  5. Tension-slide technique
License In Copyright (Rights Reserved)
Work Type Article
  1. Techniques in Orthopaedics
Publication Date September 13, 2022
Publisher Identifier (DOI)
Deposited March 06, 2023




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Work History

Version 1

  • Created
  • Added TIO-D-20-00111_R1__2_-resend_with_figures_in_PDF_format.pdf
  • Added Creator Sreenivasulu Metikala
  • Added Creator Zena Saleh
  • Added Creator Dov A. Bader
  • Added Creator Wayne J. Sebastianelli
  • Added Creator Paul S. Sherbondy
  • Published
  • Updated Keyword Show Changes
    • Distal biceps rupture, Single anterior incision, All-suture anchor, Soft anchor, Tension-slide technique