Chronic ruptures of the distal biceps tendon are uncommon and are
complicated by the retraction and poor quality of the muscle and
tendon. Surgical procedures that have been described for the treatment
of this injury are limited by the quality and availability of the
structures used for augmentation. The purpose of the present study
was to describe the surgical technique for reconstruction of the
tendon with an Achilles tendon allograft and to report our preliminary
experience with this procedure.
An Achilles tendon allograft was used to reconstruct a chronic
rupture of the distal biceps tendon in four patients. The patients
were evaluated with regard to subjective satisfaction, pain, range
of motion, and strength in flexion and supination. The results were
graded with use of the Mayo elbow performance score.
After an average duration of follow-up of 2.8 years (range, 2.0
to 3.7 years), all four patients had a satisfactory subjective result,
a full range of motion, and an excellent Mayo elbow performance
score. The strength of flexion and supination was comparable with
that on the contralateral side in two patients and was slightly
decreased in the other two.
Reconstruction of chronic disruptions of the distal biceps tendon
with an Achilles tendon allograft appears to offer a satisfactory
technical solution for this challenging problem and has provided
satisfactory clinical results to date.