Endoscopic repair of distal biceps tendon using an EndoButton

The technique of endoscopic repair of an acute rupture of the distal biceps tendon with a single anterior portal incision (1.5 cm) and fixation with an EndoButton (Acufex, Smith & Nephew, Andover, MA) is described. The ruptured biceps tendon is delivered through the portal wound and sutured to the EndoButton with a No. 5 Ethibond suture (Ethicon, Somerville, NJ). Endoscopic visualization of the tract of the avulsed biceps tendon guides the endoscopy cannula to the radial tuberosity. The endoscopy cannula serves to protect the adjacent neural structures while using the guidewire and drills for the EndoButton. The EndoButton delivers and locks the tendon into the hole in the radial tuberosity. This technique has been used in 2 patients who were allowed early active mobilization. All were satisfied, having regained a full range of elbow movement and flexion and supination strength. There have been no neurovascular complications with this technique. This report shows the utility of endoscopy in repair of the biceps tendon.