All-Endoscopic Management of Partial Tears of Distal Biceps Tendon

Background The aim of this study was to assess the sensitivity of distal biceps hook test – O’Driscoll hook test – in a retrospective series of acute and chronic distal biceps tendon tears and investigate the ability of the test to predict the need for graft reconstruction. Methods We retrospectively evaluated 234 consecutive distal biceps tendon tears operated in a single centre. The result of O’Driscoll hook test and perioperative findings of distal biceps were documented in standard fashion. Results The perioperative and O’Driscoll hook test data were available in 202 cases. The sensitivity for the distal biceps hook test was 78% in all tears and 83% in complete tears. The sensitivity was significantly lower in partial tears (30%) and in cases where lacertus fibrosus was found to be intact (45 %). When O’Driscoll hook test was positive and the delay from initial injury to operative intervention was eight weeks or more, there was over 75% probability of achilles tendon allograft reconstruction. When O’Driscoll hook test was negative, the probability of reconstruction even after 12 weeks’ delay was only 20%. Discussion O’Driscoll hook test is useful when establishing distal biceps tendon tear diagnosis, but a negative test does not exclude rupture. In delayed cases, a positive test may predict the need for reconstruction.

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Treatment of Distal Biceps Tendon Injuries with Particular Emphasis on Postoperative Physiotherapy

Ortopedia Traumatologia Rehabilitacja ◽

10.5604/01.3001.0012.3358 ◽

2018 ◽

Vol 20 (4) ◽

pp. 257-272

Author(s):

Aleksandra Królikowska ◽

Martyna Kozińska ◽

Mateusz Kuźniecow ◽

Marcin Bieniek ◽

Andrzej Czamara ◽

...

Keyword(s):

Biceps Tendon ◽

The Elderly ◽

Tendon Injuries ◽

Distal Biceps Tendon ◽

Distal Biceps ◽

Partial Tears ◽

Chronic Injuries ◽

The One ◽

Radial Tuberosity ◽

Selection Of

Distal biceps tendon injuries are relatively rare. Standard treatment of complete tears and significant partial tears involves surgical anatomical reinsertion of the tendon at the radial tuberosity. Chronic injuries are usually managed with surgical tendon reconstruction using autografts or allografts. Conservative treatment is mostly limited to the elderly, individuals with a very low level of physical activity, patients with evident contraindications to surgical treatment, and cases of mild partial tendon tears. The selection of an optimum surgical technique and method of fixation remains controversial. The aim of this paper is to characterize distal biceps tendon injuries, discuss methods of their surgical treatment, and analyze postoperative physiotherapy regimens described in the literature. A literature review did not reveal any relationship between the surgical method and type of fixation used on the one hand and the period of immobilization, type of immobilization, or the postoperative physiotherapy regimen on the other.

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Return to Sport and Weightlifting Analysis Following Distal Biceps Tendon Repair

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2021.01.034 ◽

2021 ◽

Author(s):

Anirudh K. Gowd ◽

Joseph N. Liu ◽

Bhargavi Maheshwer ◽

Grant H. Garcia ◽

Edward C. Beck ◽

...

Keyword(s):

Biceps Tendon ◽

Tendon Repair ◽

Return To Sport ◽

Distal Biceps Tendon ◽

Distal Biceps ◽

Biceps Tendon Repair

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The Role of Deadlifts in Distal Biceps Brachii Tendon Ruptures: An Alternative Mechanism Described With YouTube Videos

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967121991811 ◽

2021 ◽

Vol 9 (3) ◽

pp. 232596712199181

Author(s):

Mehmet Kapicioglu ◽

Emre Bilgin ◽

Necip Guven ◽

Anil Pulatkan ◽

Kerem Bilsel

Keyword(s):

Tendon Rupture ◽

Biceps Brachii ◽

Biceps Tendon ◽

Alternative Mechanism ◽

Distal Biceps Tendon ◽

Distal Biceps ◽

Biceps Tendon Rupture ◽

Significant Difference ◽

Biceps Brachii Tendon ◽

Youtube Videos

Background: The classic injury mechanism of a distal biceps brachii tendon rupture (DBBTR) is eccentric loading to the flexed elbow when the forearm is supinated. Purpose: To determine alternative mechanisms of a DBBTR in powerlifting sports, particularly in deadlift competitions, with the use of YouTube videos. Study Design: Descriptive epidemiology study. Methods: A search on YouTube was performed using the search terms “distal biceps tendon rupture” and “distal biceps tendon injury” combined with “competition,” “deadlift,” and “powerlifting.” The videos underwent an evaluation for accuracy by 3 surgeons according to predetermined criteria. Type of sports activity, participant sex, side of the injury, and arm positions at the time of the injury were recorded. Results: Among the videos reviewed, 35 injuries were found appropriate for an evaluation. All participants were male. The majority of the injuries (n = 25) were observed during the deadlift. Only in 1 deadlift injury were both forearms in supination. In the remaining deadlift injuries (n = 24), all elbows were in extension, with 1 forearm in supination and the other in pronation. Among the deadlift injuries in the mixed-grip position, all ruptures occurred in a supinated extremity: 25% (n = 6) of ruptures occurred on the right side, and 75% (n = 18) of ruptures occurred on the left side; this was a significant difference ( P = .014). Conclusion: We described an alternative mechanism for a DBBTR, namely, eccentric loading to an extended elbow when the forearm is supinated during the deadlift. As all the ruptures occurred in a supinated extremity, holding the bar with both forearms in pronation may prevent or decrease the risk of ruptures during the deadlift.

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Distal biceps tendon repairs and reconstructions-an analysis of demographics, prodromal symptoms and complications

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-021-03750-1 ◽

2021 ◽

Author(s):

Toni Luokkala ◽

Sijin K. Sidharthan ◽

Teemu V. Karjalainen ◽

Juha Paloneva ◽

Adam C. Watts

Keyword(s):

Biceps Tendon ◽

Distal Biceps Tendon ◽

Prodromal Symptoms ◽

Distal Biceps

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Return of an Intact Hook Test Result: Clinical Assessment of Biceps Tendon Integrity After Surgical Repair

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119827311 ◽

2019 ◽

Vol 7 (2) ◽

pp. 232596711982731 ◽

Cited By ~ 1

Author(s):

Graham D. Pallante ◽

Shawn W. O’Driscoll

Keyword(s):

Surgical Repair ◽

Biceps Tendon ◽

Distal Biceps Tendon ◽

Level Of Evidence ◽

Distal Biceps ◽

Effective Manner ◽

Distal Biceps Repair ◽

Tendon Ruptures ◽

Test Result

Background: The hook test is a sensitive and specific tool that has been previously described for diagnosing distal biceps tendon ruptures in an efficient, cost-effective manner. However, its application in postoperative evaluations after surgical repair of distal biceps tendon ruptures is not documented. Hypothesis/Purpose: We hypothesized that the hook test result returns to normal at some point postoperatively after distal biceps repair. This information could be used in decision making during follow-up examinations with both normal and abnormal findings. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: We retrospectively reviewed records of distal biceps repair. Between July 1, 2003, and July 1, 2016, a total of 56 patients underwent distal biceps repair and also had clear documentation of the results of the hook test during the postoperative period. Hook test results consisted of “intact,” “abnormal,” or “absent.” The timing of the return to a normal hook test result was recorded. Results: Overall, 51 of 57 (89%) repairs were documented to have the hook test result return to “intact.” The test result returned to intact by a mean of 10 weeks after surgery (range, 2 weeks to 15 months). The biceps tendon was intact according to the hook test at the 4-month follow-up in 45 of the 51 patients (88%) in whom it ultimately returned. The hook test result was abnormal in 5 repairs in 5 patients with only a short-term follow-up, ranging from 2 to 7 weeks postoperatively. One patient with an abnormal hook test result at 2 weeks postoperatively underwent revision and was confirmed to have a partial tear of the biceps insertion. His hook test result returned to intact 3 months after revision repair. Conclusion: The hook test result returns to normal in patients who undergo distal biceps repair in the primary and revision settings with adequate follow-up. The vast majority of patients have a normal hook test result by 4 months postoperatively. An abnormal hook test result at 4 months postoperatively may indicate a failed repair and should prompt further investigation.

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