Distal Biceps Repair

Good candidates for distal biceps repair are individuals who have sustained a distal biceps tendon tear and are experiencing significant weakness, pain, and loss of function. This may include those involved in heavy lifting or athletic activities, or those whose daily activities are significantly impacted by the injury.

The surgery can be performed using various techniques, including open repair or minimally invasive techniques.

The procedure typically begins with the administration of general or regional anesthesia.  Your elbow surgeon Dr. Mayo first makes an incision on the front of the elbow near the crease, and dissection is performed to identify the torn end of the biceps tendon while taking care to not damage any nearby nerves or blood vessels. The original tendon attachment site on the radius is then prepared for reattachment by drilling a small hole for the tendon to sit. The tendon is reattached to the radius using special devices like screws or suture anchors. The incision is closed, and a bandage is applied.

Recovery timelines vary, but generally, patients can return to light duty work or desk jobs within 1-2 weeks after surgery. Full recovery and return to heavy lifting or sports can take up to 4-6 months. This timeline allows the tendon to heal and for the arm to regain strength and flexibility.

Immediately after surgery, the arm is typically immobilized in a splint or brace to protect the repair. You will go home an hour or two after surgery ends. Pain is to be expected, and medications will be prescribed to help manage it. Physical therapy will begin soon after surgery to start gentle range-of-motion exercises.

Physical therapy is an essential component of recovery. It will be customized to your needs and can generally be divided into three stages:

• Early Stage: The focus is on gentle range-of-motion exercises to avoid stiffness.
• Middle Stage: As healing progresses, strengthening exercises will be introduced.
• Late Stage: The final stage focuses on returning to normal function, including lifting and sports-specific movements.

All surgeries carry some risk. For distal biceps repair, potential complications include:

• Infection: Occurs in less than 1% of patients.
• Nerve Injury: There are nerves near the surgical area that can potentially be injured during surgery, resulting in temporary or permanent numbness in the forearm or hand.
• Re-rupture: There is a risk of re-rupturing the repaired tendon, especially if the post-operative protocol is not followed. This is rare, but can occur.
• Stiffness: Some patients may experience a limited range of motion after surgery. This occurs in less than 10% of cases.

If left untreated, a distal biceps tear can lead to:

• Persistent Weakness: The biceps muscle is essential for elbow flexion and forearm rotation. Without surgical repair, patients may experience significant and permanent weakness in these movements.
• Pain and Discomfort: Some patients may have ongoing pain or discomfort in the elbow.
• Limited Function: Without surgical repair, some patients may be unable to perform their usual activities, including sports or occupations that involve heavy lifting.