No functional differences in anatomic reconstruction using a one- versus a two-point fixation for distal biceps tendon rupture through a single-incision anterior approach: A prospective randomized trial

Abstract

BACKGROUND: The distal biceps brachii tendon rupture is a rare injury of the musculoskeletal system. Multiple surgical techniques have been described for distal biceps brachii tendon repairs including suture anchors. OBJECTIVE: The aim of this study was to evaluate the outcome of anatomical distal biceps tendon refixation using either one or two suture anchors for reattachment and to determine whether there are significant clinically important differences on the number of anchors used for refixation. METHODS: A monocentric, randomized controlled trial was conducted, including 16 male patients with a mean age of 47.4 years (range, 31.0 to 58.0) in Group 1 (two suture anchors for refixation) and 15 male patients with a mean age of 47.4 (range, 35.0 to 59.0) in Group 2 (one suture anchor for refixation). All surgeries were performed through an anterior approach. The outcome was assessed using the Oxford Elbow Score (OES), the Mayo Elbow Performance Score (MEPS), the Disabilities of the Arm, Shoulder and Hand (DASH) score, the Andrews Carson Score (ACS) and by isokinetic strength measurement for the elbow flexion after six, twelve, 24 and 48 weeks. Radiographic controls were performed after 24 and 48 weeks. RESULTS: No significant differences between both groups were evident at any point during the follow-up period. A continuous improvement in outcome for both groups could be detected, reaching an OES: 46.3 (39.0 to 48.0) vs. 45.5 (30.0 to 48.0), MEPS: 98.0 (85.0 to 100.0) vs. 99.0 (85.0 to 100.0), DASH: 3.1 (0.0 to 16.7) vs. 2.9 (0.0 to 26.7), ACS: 197.0 (175.0 to 200.0) vs. 197.7