Infected distal biceps tendon repairs: three case reports

Numerous reports address the risk of infection with surgery about the elbow. However, there is little information regarding treatment of infected distal biceps repairs. We reviewed the records of 37 consecutive patients with biceps repairs between January 1, 2000, and January 1, 2005, to identify cases of postoperative infection. Three patients were identified and their records examined to identify the responsible organisms and any forms of treatment. Two patients presented acutely less than 4 weeks after surgery with frank purulence draining from the incision area. The third patient presented 4 months after tendon repair. In both patients with acute infection, the infection resolved without removal of any stitches or hardware. In the patient with chronic infection, the anchoring material was removed because it was no longer holding the biceps tendon to the radial tuberosity. These data suggest acute infections can be treated with antibiotics and débridement without taking down the tendon repair. However, as with any chronic musculoskeletal infection, all foreign material may need removal before a second repair. Our data demonstrate deep infection is not an uncommon complication of distal biceps tendon repairs that initially can be treated without taking down the construct.