Distal biceps tendon repair: anchor versus transosseous suture fixation

Suture anchor fixation and transosseous suture fixation were compared in 12 fresh-frozen cadaveric radii using either No. 2 braided polyester suture or single Mainstay 3.5-mm threaded anchors (made at the time by Howmedica, Rutherford, NJ) with No. 2 suture. Suture fixation failed at a mean strength of 162 N (range, 129-179 N), anchor fixation at 136 N (range, 121-150 N). Neither technique is strong enough to safely allow immediate biceps activity. Nevertheless, suture anchor fixation to the radial tuberosity offers a lower but clinically comparable strength to transosseous suture fixation while limiting postoperative risks.