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Updated: Apr 24, 2026

Knotless Independent Double-Row Repair and Biceps Augmentation for Anterosuperior Rotator Cuff Tears
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Distal biceps tendon repair using cortical button with or without interference screw: A comparative study.

Spilios Dellis1, Nifon K Gkekas2, Alexandros Stamatopoulos3

  • 1Department of Trauma and Orthopaedics, Lewisham and Greenwich NHS Foundation Trust, London, UK.

Shoulder & Elbow
|April 23, 2026
PubMed
Summary
This summary is machine-generated.

Cortical button (CB) alone or with an interference screw (CBIS) both yield excellent outcomes for distal biceps tendon repair. This study found no significant clinical differences, suggesting CB fixation may suffice for routine repairs.

Keywords:
Distal biceps tendonMEPSQ-DASHclinical outcomescortical buttoninterference screwtendon repairtendon rupture

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Area of Science:

  • Orthopedic surgery
  • Sports medicine
  • Tendon repair

Background:

  • Distal biceps tendon ruptures require surgical repair.
  • Current techniques include cortical button (CB) fixation alone or combined with an interference screw (CBIS).
  • Direct clinical comparisons of these techniques are limited.

Purpose of the Study:

  • To compare clinical and functional outcomes of distal biceps tendon repair using CB versus CBIS.
  • To evaluate patient-reported outcomes and complication rates between the two fixation methods.

Main Methods:

  • Retrospective comparative study of 55 patients with acute distal biceps tendon rupture (2019-2024).
  • Patients were treated with either CB (n=27) or CBIS (n=28) based on surgeon preference.
  • Outcomes assessed at minimum 12 months included Mayo Elbow Performance Score (MEPS), Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH), Visual Analogue Scale (VAS), complications, and return to activity.

Main Results:

  • No statistically significant differences were observed between the CB and CBIS groups in MEPS (96.3 vs 97.1) or Q-DASH (2.8 vs 2.2) scores.
  • Mean follow-up was comparable (21.6 months for CB, 19.8 months for CBIS).
  • Complication rates and return to activity data were not significantly different between groups.

Conclusions:

  • Both cortical button fixation alone and combined cortical button with interference screw fixation provide excellent short- to mid-term outcomes for distal biceps tendon repair.
  • No clinically significant differences were detected between the techniques.
  • Surgeon-specific practice patterns indicate that CB fixation alone may be sufficient for routine acute distal biceps tendon repair.