Distal biceps repair using the lacertus fibrosus as a local graft

We report a case series of 15 patients who underwent a new surgical technique that uses a transfer of the lacertus fibrosus to augment the repair of the distal biceps tendon. This technique seeks to minimize the need for and potential complications associated with autogenous or allograft tendon reconstruction in this clinical scenario.

We reviewed the clinical outcomes of patients who both underwent a lacertus transfer for biceps tendon reconstruction during a 10-year period and had at least 6 months of follow-up. Their clinical outcomes, including success of tendon repair, functional performance, and associated surgical complications, were evaluated.

During a 10-year period, 244 patients underwent surgery for repair or reconstruction of the distal biceps tendon. During this time, 15 patients met the criteria for use of the lacertus transfer technique. When direct repair was not possible because of tendon retraction and attrition, although a tendon graft was considered, the intact lacertus fibrosus was used to augment the biceps repair. Of these 15 patients, 12 met study inclusion criteria. At latest follow-up, all 12 patients were successfully treated by the lacertus transfer without complication, had regained elbow flexion and forearm supination strength, and had no lacertus harvest complications.

When operative treatment is chosen for biceps tendon injuries and if the lacertus fibrosus is intact, transfer of the lacertus to augment repair of the distal biceps provides predictable outcomes without the potential complications associated with allograft or autograft tendon reconstruction.