Distal Biceps Tendon Repair

There are many different techniques for repairing the ruptured biceps tendon. This is our prefered method, but other methods are equally successful. Please discuss with your surgeon.

The biceps tendon ruptures off the forearm bone (radius) and retracts up the upper arm, causing a deformity (known as the 'Popeye sign')

Click for larger view of biceps rupture

A small incision is made over the upper forearm, where the biceps should attach onto the radius bone.

The retracted biceps tendon is retrieved through the incision. Sometimes another incision higher up the arm may be required to find the tendon.

The radius is prepared to encourage healing.

Two suture-anchors   are inserted into the bone as an anchorage for the tendon.

The strong sutures from the suture-anchors   are thread through the tendon in a specific interlocking way to ensure a strong repair of the tendon to the bone.

After the surgery a hinged elbow brace is applied with the elbow locked at 60-90 degrees of flexion. The brace is adjusted by your surgeon or therapist at two weekly intervals to gradually allow more movement. By six weeks you should be able to remove the brace.
ROM Elbow Deluxe

Physiotherapy is essential after the surgery, as we allow passive motion of the elbow from the limits of the brace. This should be arranged after your surgery. Click here for details of the Physiotherapy programme.

It can take up to 6-12 months to regain the full strength of your biceps.

Result at one year post-op:


Information for your Biceps Repair Surgery

You must not eat or drink anything after midnight the day before your surgery. When you wake up following the procedure you will be wearing a hinged elbow brace.

The operation is usually a day-case procedure, so you should be able to go home about 4 hours after the operation. A physiotherapist will see you in hospital to teach you the appropriate exercises. You may also see an occupational therapist to give you advice regarding the use of your arm.


Local anaesthetic is usually used during the surgery (in addition to a general anaesthetic). This means that immediately after the operation elbow should be pain-free. This may last for a few hours. It is esential you take the painkillers from the hospital as soon as you get home and keep taking them regularly. You may need them for a few weeks. Cold compression wraps may also help reduce pain. Or you can use crushed ice or frozen peas in a damp, cold cloth and place on your elbow for up to 15 minutes. Ensuring you cover the wound site with a piece of cling film to keep the area dry. For more information click here


This operation is usually done through one or two or small incisions. There will usually be a dissolving suture in the wounds, with a small loop over the top, and small sticking plaster strips over the wounds. These should be kept dry until healed. You may shower with waterproof plasters in the meantime. You can remove the brace to do so, but do not move your elbow. The suture loop can be trimmed at two weeks, at your follow-up appointment. 


An appointment will be made for you to see the surgeon or specialist therapist 3 weeks post-operatively. 


For the first three weeks all activities of daily living for example feeding, dressing, cooking etc must be carried out using your un-operated arm. If appropriate an occupational therapist will be available to give you advice on how to do this. For more information Click Here.


Your physiotherapist and surgeon will advise you when it is safe to resume your leisure activities. This will vary according to your sport and level, as well as the period required to retrain your muscles with physiotherapy.


You will not be able to drive for a minimum of 6 weeks. Your surgeon will confirm when you may begin.


This will depend upon the size of your tear and your occupation. You will need to discuss this with your surgeon.

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