Rerupture and Total Complication Rate After Single-Incision Power Optimizing Cost-Effective Distal Biceps Repair.

PURPOSE: The single-incision power optimizing cost-effective (SPOC) technique for distal biceps tendon repair reattaches the tendon to its native anatomical site, maximizing supination strength while minimizing surgical morbidity. Long-term follow-up data on the SPOC technique remain limited, and debate remains surrounding the optimal fixation strategy for distal biceps tendon repair. This study aims to evaluate the complication rates of patients undergoing SPOC distal biceps tendon repair.

METHODS: A retrospective chart review was performed on all patients who underwent SPOC distal biceps repair between 2016 and 2024 by two surgeons at the same center. Inclusion criteria included primary distal biceps repair with the SPOC technique and greater than 12 weeks of follow-up. Exclusion criteria included revision surgery, allograft use, non-SPOC repair technique, and less than 12 weeks of follow-up. Complete or partial rupture of the distal biceps tendon was recorded based on intraoperative findings. The resulting cohort of 84 arms was analyzed with rerupture as the primary endpoint. Secondary endpoints were nonrerupture complications, reoperation, operative time, and tourniquet time.

RESULTS: Out of 84 arms, 52 (61.9%) were complete ruptures and 32 (38.1%) were partial ruptures. There were no documented reruptures and a total complication rate of 22/84 (26.2%). The mean operative time was 78.2 ± 21.4 minutes with a mean tourniquet time of 66.9 ± 19.2 minutes. Seventeen arms had nonoperatively managed lateral antebrachial cutaneous nerve paresthesias, one had nonoperatively managed heterotopic ossification, and one had persistent tendinitis. The return to OR rate was 3.6%, with one heterotopic ossification excision, one lateral antebrachial cutaneous nerve neurolysis, and one tenolysis for soft tissue tethering.

CONCLUSIONS: This study supports the use of SPOC distal biceps repair for both partial and complete biceps ruptures, with a low rerupture rate, similar complication rate to other commonly used techniques, and low return to OR rate.

TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic IV.