Distal Bicep Tendon Repair

Distal Bicep Tendon is a common cause of pain and stiffness around the upper arm which can severely affect your quality of life.

Overview

The biceps muscle is the muscle on the front of your upper arm. It has two important functions; it bends (flexes) the elbow joint and rotates the forearm to a palm up position. If the bicep tendon ruptures, you will have permanent weakness without surgical repair.

Causes & Symptoms

A rupture of the biceps most often occurs when the elbow is being pulled in to a straightened (extended) position while it is actively trying to do the opposite. Common causes include lifting weights or other objects that are too heavy or one-arm waterskiing. 

Often there is a degenerative process that affects the tendon and during a sudden/forceful forearm flexion you can experience a stabbing pain with a snapping sensation followed by deformity of the arm and bruising soon after. Weakness can be moderate or profound at the beginning but a partial recovery has to be expected in the following months.

Diagnostics

A clinical diagnosis is often easy because of the local deformity. X-rays might sometimes show a fracture of the tendon ridge (radial tuberosity) in rare cases but an ultrasound scan is paramount to confirm a diagnosis. In some cases an MRI is useful to identify the level of retraction of the tendon and fatty degeneration of the muscle.

Treatment

Conservative management in sedentary patients is a viable option but surgical repair, especially in acute conditions, is often preferred. It involves reattachment of the tendon to the radius bone. There are different techniques depending on the situation, but most often stitches are put through the distal biceps tendon and then pulled through a suture anchor or device positioned in the radius bone to rejoin the tendon to its original location. This will allow the tendon to heal back to the bone.

Aftercare

After surgery you will be required to use a brace or a back slab for a period of time and complete a comprehensive rehabilitation programme, that might last 3-4 months in total. Your therapist will guide you through this process and make adjustments that are necessary to your individual needs and situation.

In some cases a full repair might not be possible and in these cases soft tissue graft implants might be needed to reconstruct the retracted tendon.

You will see your consultant two weeks after surgery and then your physiotherapist. Light work at a desk can start between 2-3 weeks after surgery. Driving will be possible 4-5 weeks after surgery. After 16 weeks you should be able to return to sport specific training.

Treatments are available at the following locations

Schoen Clinic London

Our Address
Schoen Clinic
Orthopaedic and Spinal Hospital London
66 Wigmore Street
London W1U 2SB
General Telephone Enquiries
+44 (0)203 929 0801
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Specialists

Mr Adrian J Carlos

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Mr Giuseppe Sforza

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Dr Philip Batty

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