A new technique - In vitro suture anchor fixation has superior yield strength to bone tunnel fixation for distal biceps tendon repair

Background: Suture anchor and bone tunnel fixations are used for distal biceps tendon repairs and have not been compared. Hypothesis: Suture anchor fixation is equal or superior to bone tunnel fixation. Study Design: Randomized controlled in vitro study. Methods: A new fixation technique was compared to traditional bone tunnel fixation of distal biceps tendon ruptures between randomly selected sides of nine matched-pair, fresh-frozen elbow specimens from cadaveric donors (mean age = 74.7 years). Bone densities were determined. The distal biceps tendon was attached to the actuator of a servohydraulic load frame and loaded to tensile failure at a constant rate of 4 mm/sec. Bone density, sex, age, side, tuberosity area, repair, failure type, repair stiffness, and yield strength were compared. Results: Superior yield strength of suture anchor fixation (263 N) compared to bone tunnel fixation (203 N) (P = 0.0233) were demonstrated. When suture anchor fixation failure (11 of 9) occurred, the matched pair also failed. Conclusion: Suture anchor fixation offers an equal if not superior alternative to bone tunnel fixation for repair of the distal biceps tendon in the specimens tested. Clinical Relevance: Suture anchor fixation may be used for distal biceps tendon repairs.