Distal Bicep Tendon Repair Utilizing Knotless Retensionable All-Suture Anchors

The incidence of distal bicep tendon ruptures is low, yet surgical repair is important to restore function. The retensionable knotless distal biceps tendon repair with the all-suture anchor technique involves placing 2 knotless all-suture anchors in the radial tuberosity. Repair sutures are passed through and around the distal biceps tendon, and a tensioning strand is tightened to reduce the tendon down to the bone. One limitation of this technique is that the biomechanical strength utilizing a suture anchor technique has a lower load to failure compared to the classic cortical button technique. Despite this shortcoming, the potential advantages should not be ignored. This includes the ability to place the repair in an anatomic position and the ability to retension the construct as many times as necessary. It also minimizes potential complications, such as fracture and injury to the posterior interosseous nerve.