Consultant upper-limb surgery · London
Private distal bicep tendon repair in London, by a consultant upper-limb surgeon.
Surgical reattachment of a ruptured distal biceps to the radial tuberosity — repaired inside the four-week window by a named elbow surgeon, with the anaesthetic that suits you and a proper rehab plan afterwards.
Why patients choose us
- 01
A consultant upper-limb surgeon
A named elbow and shoulder surgeon — not a general orthopod — with a working list of distal biceps cases, not a once-a-year procedure.
- 02
Repaired inside the four-week window
A complete tear retracts and scars quickly. We aim to get you assessed, imaged and in theatre before the graft conversation becomes necessary.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private distal bicep tendon repair costs in London.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three surgeons.
In short
A single-incision cortical-button repair in our network: £7,500–£11,500, home the same day.
| Procedure | Indicative range | Typical duration | Stay |
|---|---|---|---|
| Single-incision distal biceps repair (cortical button) | £7,500–£11,500 | 60–90 min | Day-case |
| Two-incision Boyd–Anderson repair | £8,000–£12,500 | 75–100 min | Day-case |
| Chronic repair with tendon graft (allograft or hamstring) | £11,000–£16,000 | 120–150 min | Day-case or 1 night |
| Consultant upper-limb review + clinical hook test | £250–£450 | 30–45 min | Same visit |
| Musculoskeletal MRI of the elbow | £450–£750 | 30 min | 24–48 h |
| Physiotherapy course (post-op rehab, 6 sessions) | £450–£900 | 45 min each | Weekly |
Prices vary by clinic, by the surgeon, by whether a graft is needed, and by the anaesthetic (regional block plus GA vs GA alone). We come back with a firm quote within one working day.
The problem
The right surgeon, the right window, the right rehab.
Distal biceps ruptures are quietly one of the most time-critical elbow injuries. Miss the four-week window and a straightforward repair becomes a graft operation. Rush the rehab and you re-rupture. Both are avoidable.
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Not sure it is torn?
Bruising, a “reverse Popeye” bulge and weak supination point to a complete tear. An MRI within days settles it.
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Worried about the PIN nerve?
A surgeon who does these regularly knows exactly where the PIN is — and which approach to use to protect it.
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Want your supination back?
Repaired inside four weeks, then rehabbed properly, most patients regain near-full flexion and supination strength.
The journey
From enquiry to full loading — what happens, in order.
Imaging, decision, early surgery inside the four-week window, and a phased rehab all the way to full loading.
Phase 1 · Before your surgery
Concierge, off-stage for you
Phase 2 · On the day
A day-case at the clinic
Phase 3 · Rehab
Concierge, back on
- 01
Before
You tell us what happened
A short, confidential form. When the pop went, which arm, how much bruising, and how weak supination feels now.
- 02
Before
MRI to confirm the tear
Within a few days: an MRI to confirm complete versus partial rupture and how far the tendon has retracted. Clinical hook test alongside.
- 03
Before
Surgeon review and decision
Consultant upper-limb surgeon within one working day of the scan — single-incision versus two-incision, or non-operative if your demand profile fits.
- 04
On the day
Arrival at the theatre
Consent, block or general anaesthetic, and a marked arm. Distal biceps repair is a day-case procedure in almost every case.
- 05
On the day
The repair itself
Around 60 to 90 minutes. Tendon reattached to the radial tuberosity with a cortical button and interference screw, or via the two-incision Boyd–Anderson approach.
- 06
On the day
Home the same day
A sling, written aftercare and pain relief. You will need someone to drive you home from a GA.
- 07
After
Phased rehab, six to nine months
Sling for one to two weeks, active-assisted range at two, no resisted supination until 8–12 weeks, gym at 4–6 months, full loading at 6–9 months.
Typical end-to-end: 1–3 weeks from enquiry to theatre. Full loading: 6–9 months.
When it helps
When distal bicep tendon repair is the right step.
The presentations we see most, plus the one red flag that means calling the surgeon before your next scheduled appointment.
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Sudden pop lifting or catching
A classic eccentric loading injury — a heavy lift, a falling load caught mid-air, an audible pop and immediate pain in the front of the elbow.
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Bruising in the antecubital fossa
Deep bruising in the crease of the elbow within 24–48 hours is the tell-tale sign of a distal biceps tear.
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“Reverse Popeye” deformity
The muscle belly retracts up the arm, leaving a visible bulge higher than it should be — a proximal lump, not a distal one.
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Weakness in supination and flexion
Supination weakness is worse than flexion weakness — turning a screwdriver, a doorknob or a wine bottle feels wrong.
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Partial tear that will not settle
A partial tear with ongoing pain and weakness despite rest, ice and physiotherapy — often needs completion and repair.
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Middle-aged, active, want function back
The typical patient — 35 to 55, still lifting, cycling or playing sport, and unwilling to accept 30–40% supination loss.
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Chronic tear presenting late
A tear picked up weeks or months after the event — retracted and scarred. Still repairable, but often needs a graft to bridge the gap.
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Red flag: numb or drop wrist after op
A wrist that will not extend, or finger extensors that will not fire, after surgery is a PIN nerve problem — call the surgeon the same day.
Procedure options
Single-incision, two-incision, or a graft — the honest options.
What each surgical window and each anaesthetic actually involves — and which fits which patient.
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Single-incision anterior (cortical button)
The modern standard. One transverse incision at the elbow crease; tendon fixed to the radial tuberosity with a cortical button and interference screw. Strong fixation, early rehab.
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Two-incision Boyd–Anderson approach
A small anterior incision to retrieve the tendon and a posterolateral incision to fix it. Chosen to keep the dissection away from the PIN nerve — at the cost of a second scar and radioulnar synostosis risk.
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Chronic repair with tendon graft
For tears presenting beyond three to four weeks the tendon retracts and scars. A graft (semitendinosus autograft or allograft) bridges the gap so the muscle still reaches the tuberosity.
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Non-operative management
A reasonable option for older, low-demand or non-dominant-arm patients who can accept roughly 30–40% loss of supination strength and around 15% loss of flexion strength.
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Partial-tear debridement
For confirmed partial tears that fail conservative treatment — the frayed tendon is completed and repaired as a formal reattachment.
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Regional block plus GA
A supraclavicular or interscalene block gives 12–24 hours of post-op pain relief. Combined with a light GA it is the standard anaesthetic for this procedure.
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Post-op physiotherapy programme
A structured 6–9 month programme: passive to active-assisted to active range, then loaded strength. Rushing supination is the single biggest cause of re-rupture.
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Consultation only
An honest discussion — whether surgery is right for you, which approach, and what your realistic strength and timeline look like.
Our vetted London network
A small panel of upper-limb surgeons, we picked them.
Consultant elbow and shoulder surgeons across central, north, west and south London. Not listed publicly — introductions are made privately, once we understand your injury.
Selection criteria
How we choose every upper-limb surgeon in our network.
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Consultant upper-limb (elbow and shoulder) surgeons, not general orthopaedic trainees
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A working annual volume of distal biceps repairs, not the occasional case
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Both single-incision and two-incision techniques offered, chosen for the patient
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A named post-op physiotherapist working to a distal biceps rehab protocol
Safety and recovery
What can go wrong — and how we minimise it.
Distal bicep repair is a good operation done by the right surgeon. It also has specific, well-described complications — worth understanding before you sign the consent form.
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PIN (posterior interosseous nerve) injury
The most serious specific complication — a stretch or transection of the PIN causes wrist drop and finger extension weakness. Usually neuropraxic and recovers, but can be permanent.
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LABCN neuropathy is common
The lateral antebrachial cutaneous nerve runs right where the incision goes. Numbness or tingling in the forearm affects up to 40% of patients; most settle within 3–6 months.
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Heterotopic ossification
Bone forms in soft tissue around the elbow in a minority of patients, occasionally limiting rotation. Two-incision technique carries a slightly higher risk.
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Radioulnar synostosis
A rare but serious complication of the two-incision approach — bone bridge between radius and ulna locks rotation and needs surgical release.
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Re-rupture (1–5%)
Uncommon, and almost always caused by loading supination too early. The rehab timeline is not optional.
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Infection and DVT
Superficial infection is uncommon and treated with antibiotics; deep infection is rare. DVT risk is low for a day-case upper-limb procedure but not zero.
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Anaesthetic and cardiac risk
A block-plus-GA anaesthetic is low risk for a healthy adult, but cardiac events during anaesthesia — while rare — are worth knowing about and pre-assessing.
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Timing matters — the four-week window
Repaired inside three to four weeks: primary reattachment. Beyond that, retraction and scarring often force a graft — a bigger operation with a slower recovery.
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Red flags after surgery
A wrist that will not lift, spreading redness, escalating pain, fever or a calf that is hot and swollen — call the surgeon or A&E the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever technique was used, the note the surgeon sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Injury, side and time from tear
When the tear happened, which arm, dominant or non-dominant, and how many days elapsed between injury and surgery.
- 02 Technique
Approach and fixation
Single-incision or Boyd–Anderson, cortical button, interference screw, suture anchors, and whether a graft was needed.
- 03 Findings
Tendon quality and nerve status
Notes on the retracted tendon, how the tuberosity looked, and whether the PIN and LABCN were identified and protected.
- 04 Impression
Rehab plan and return-to-loading timeline
Read this first: sling duration, when supination becomes safe, gym clearance and the expected return-to-sport date.
Recognised by major UK insurers
Distal biceps tendon repair is almost always covered as an acute injury when medically indicated. We confirm cover in writing with your insurer before booking.
Frequently asked
Everything we get asked about distal bicep tendon repair.
Quick answers on timing, technique, recovery and cost.
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How do I know if I have actually torn my distal biceps?
The story is usually clear — a sudden pop lifting or catching, immediate pain in the front of the elbow, bruising over the next day or two, weakness turning things (supination) and a “reverse Popeye” bulge higher up the arm. A clinical hook test and an MRI confirm it.
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Do I have to have surgery?
No. Non-operative management is reasonable for older or low-demand patients — the trade-off is roughly 30–40% loss of supination strength and around 15% loss of flexion strength. For active middle-aged patients who use their arm to lift or work, surgery is usually recommended.
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How urgent is the surgery?
Ideally within three to four weeks. After that the tendon retracts and scars, and a primary repair often becomes a graft repair — a bigger operation with a longer recovery. If you suspect a tear, get imaged this week, not next month.
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Single-incision or two-incision — which is better?
Both work. The single-incision anterior approach with a cortical button is the modern standard and gives strong early fixation. The two-incision Boyd–Anderson approach protects the PIN nerve at the cost of a second scar and a slightly higher risk of radioulnar synostosis. Your surgeon picks the one that fits your anatomy and injury.
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What is the recovery timeline?
Sling for one to two weeks, active-assisted range from around two weeks, no resisted supination until 8–12 weeks, return to the gym at 4–6 months, and full loading and contact sport at 6–9 months. Rushing supination is the single biggest cause of re-rupture.
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How much does distal biceps tendon repair cost privately in London?
Roughly £7,500–£11,500 for a single-incision cortical-button repair, £8,000–£12,500 for a two-incision Boyd–Anderson, and £11,000–£16,000 if a graft is needed for a chronic tear. MRI is around £450–£750 and a rehab course of six physiotherapy sessions is £450–£900.
Related tests
Looking for something else?
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Shoulder arthroscopy
Keyhole surgery for shoulder pain and instability.
Learn more -
Musculoskeletal MRI
The scan that confirms tendon, ligament and joint injuries.
Learn more -
Nerve conduction studies
For suspected PIN or peripheral nerve injury.
Learn more -
All tests
Every test and procedure we arrange.
Learn more