Short-term clinical and functional outcomes of distal biceps tendon fixation: all-suture vs. titanium anchors

The objective of this study was to evaluate the preliminary clinical and functional outcomes of patients with distal biceps tendon ruptures undergoing surgical fixation using 2 intramedullary all-suture anchors (ASAs) and to compare these outcomes with a control group treated with 2 intramedullary titanium anchors (TAs).

A retrospective case series was conducted on patients who underwent distal biceps tendon fixation using either TAs (Mitek Sports Medicine, Raynham, MA, USA) or ASAs (Arthrex, Naples, FL, USA). Clinical and functional outcomes were evaluated at a mean follow-up of 24 months, using the Mayo Elbow Performance Score, Quick Disabilities of the Arm, Shoulder, and Hand Questionnaire, and visual analog scale. Secondary assessments included isometric strength testing with the IsoForce Control Dynamometer (IsoForce, Dübendorf, Switzerland) and the identification of postoperative complications, such as heterotopic ossification (HO).

A total of 53 patients (23 ASA, 30 TA) were included in the final analysis, with ASA patients being slightly younger (55.2 ± 9.8 years vs. 63.2 ± 7.7 years, P < .05) and the only group to include females (4), as the TA cohort comprised exclusively male patients. The average follow-up duration was 33.8 ± 9.3 months for the ASA group and 45.4 ± 11.1 months for the TA group. HOs were significantly more prevalent in the TA group (37.5% vs. 17.2%, P < .05). Functional outcomes, measured by Mayo Elbow Performance Score and QuickDASH, and strength recovery ratios were comparable across both groups, though ASA patients demonstrated higher absolute isometric strength values at specific flexion angles (P < .05). Both anchor systems delivered equivalent functional and clinical outcomes after 1 year postoperatively.

Both, ASAs and TAs, achieved excellent functional and clinical outcomes in distal biceps tendon fixation with low complication rates. ASA demonstrated significant fewer HOs compared to TA.