Distal Biceps Tendon Reconstruction With Tendoachilles Allograft: A Modification of the Endobutton Technique Utilizing an ACL Reconstruction System

Distal biceps tendon ruptures typically occur with biceps contraction against resistance with the elbow flexed at 90°. Anatomic repair is the gold standard in active patients. Numerous surgical techniques are available; however, the Endobutton might offer several advantages. We describe a novel technique for chronic distal biceps reconstruction using a modification of the Endobutton technique with an anterior cruciate ligament (ACL) drill guide as well as tendoachilles allograft. The Endobutton technique might offer several advantages, including direct tendon-to-bone healing, less bony debris to limit heterotopic ossification, less heating of the bone, ease of use, a biomechanical superiority, and excellent clinical outcomes.