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Biomechanical analysis suggests early rehabilitation is possible after single-incision EndoButton distal biceps repair with FiberWire



Previous studies that have encouraged early postoperative motion after distal biceps repair shows little agreement on exactly when activity should be resumed after surgery or on the level of weight restriction that should be used. The aim of the current study was to define a service load that would permit, without failure, 2,000 cycles of immediate motion after single-incision EndoButton distal biceps repair with FiberWire.


In each of 15 cadaveric elbows, the distal biceps tendon was divided at its insertion and then repaired using a single-incision EndoButton technique with FiberWire. The repairs were then challenged according to the “staircase method” by cyclically loading the biceps tendon, so that the forearm flexed between 0° and 90°.


The mean failure load of the repair was 166.7 N (95% confidence interval, 132.6–200.8). The data suggested that a 0.9 kg (9-N) weight at the hand was the limit for a 2,000-cycle early rehabilitation protocol after repair of a ruptured distal biceps tendon via a single-incision EndoButton repair technique.


Early active motion with a 0.9-kg weight restriction may therefore be possible in those patients undergoing distal biceps tendon repair using this technique.

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The authors received a donation of EndoButton devices only from Smith and Nephew. Dr. David Rose also received financial support for his fellowship from Finsbury Orthopaedics, UK.

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Correspondence to John H. Wilckens.

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Rose, D.M., Archibald, J.D., Sutter, E.G. et al. Biomechanical analysis suggests early rehabilitation is possible after single-incision EndoButton distal biceps repair with FiberWire. Knee Surg Sports Traumatol Arthrosc 19, 1019–1022 (2011).

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  • Distal biceps repair
  • EndoButton
  • Rehabilitation
  • Biomechanical analysis