Distal Biceps Tendon Repair Overview
Individuals who suffer a distal biceps tendon tear (at the elbow) may wish to consider a surgical distal biceps tendon repair as their primary treatment method. Dr. Millett recommends surgery for active individuals who need to maintain normal arm strength. Surgery helps to restore strength and function and it prevents cramping and retraction of ruptured biceps tendon further up into the arm. If the injury occurs and treatment is delayed, it can be more difficult to repair the biceps tendon because of scarring and loss of the tendon. In some instances a tendon graft from somewhere else in the body or from a cadaver may be needed to reconstruct (rebuild or substitute for) the chronically torn biceps tendon.
In the appropriate individuals, Dr. Millett recommends direct surgical repair of the torn biceps tendon. This is known as a distal biceps tendon repair. This is preferably done right after the injury occurs and swelling has subsided. Dr. Millett prefers to use a minimally-invasive reconstruction, single incision approach, as this has lower risk of complications and great outcomes.
There is not an option for arthroscopic surgery to fix this, but the incision used is very small (less than one inch). Using a single, small incision across the middle of the front of the arm, Dr. Millett uses tiny instruments to enter the arm and grab the disconnected tendon. After removing damaged collagen fibers from the torn end of the tendon, the biceps tendon is reattached to the correct location on the radius (forearm bone on thumb side) with surgical sutures and special bone anchors.
In more chronic situations where the biceps tendon is actually no longer present, Dr. Millett may opt to use a graft to rebuild the torn biceps tendon and perform a minimally-invasive reconstruction. During a distal biceps tendon repair, a graft (cadaver tissue or hamstring tendon) is used to rebuild the torn biceps tendon. The graft is sewn into the native biceps muscle and then sewn back into the bone. This is a more involved procedure, but it can still result in excellent function in more challenging cases.