Failure of the Interference Tenodesis Screw After Distal Bicep Tendon Repair With a Suture Button Technique: A Report of Two Cases

Distal bicep tendon rupture is an uncommon form of bicep rupture which is typically seen in middle-aged men. We identified two cases in which the distal bicep tendon rupture was repaired with an EndoButton™ (Smith and Nephew, Watford, UK) and interference screw with preservation of the EndoButton™​ but a failure of the interference screw. This report highlights the addition of a FiberWire(®) (Arthrex, Inc., Naples, Florida, USA) construct to secure the interference screw from backing out and emphasizes the EndoButton™ as the primary biomechanical anchor in maintaining a successful distal bicep tendon repair. We question the necessity of both the interference screw and EndoButton™ in the fixation of the distal bicep tendon and recommend that securing the interference tenodesis screw with an additional FiberWire(®) may provide a more secure fixation of the screw as compared to traditional approaches.