scholarly journals Determining the incidence and risk factors for short-term complications following distal biceps tendon repair

2022 ◽  
Author(s):  
Cody Goedderz ◽  
Mark A. Plantz ◽  
Erik B. Gerlach ◽  
Nicholas C. Arpey ◽  
Peter R. Swiatek ◽  
...  
Keyword(s):  
Risk Factors ◽  
Functional Status ◽  
Surgical Complications ◽  
Biceps Tendon ◽  
Tendon Repair ◽  
Short Term ◽  
Distal Biceps Tendon ◽  
Distal Biceps ◽  
Distal Biceps Repair ◽  
Biceps Tendon Repair

Background: Distal biceps rupture is a relatively uncommon injury that can significantly affect quality of life. Surgical repair has the potential to provide functional improvement for patients. However, early complications following biceps tendon repair are not well described in the literature. This study aims to utilize a verified national surgical database to determine the incidence of and predictors for various short-term complications following distal biceps tendon repair. Methods: The American College of Surgeons’ National Surgical Quality Improvement Program database was used to identify patients undergoing distal biceps repair between January 1, 2011, and December 31, 2017. Patient demographic variables of sex, age, body mass index (BMI), American Society of Anesthesiologists class, functional status, and several comorbidities were reported for each patient, along with various 30-day postoperative complications. Binary logistic regression was used to calculate risk ratios for these complications using patient predictor variables.Results: Early postoperative overall surgical complications (0.5%)—which were mostly infections (0.4%)—and overall medical complications (0.3%) were rare. A risk factor for readmission was diabetes (risk ratio [RR], 4.238; 95% confidence interval [CI], 1.180–15.218). Risk factors for non-home discharge were smoking (RR, 3.006; 95% CI, 1.123–8.044) and 60 years of age (RR, 4.150; 95% CI, 1.611–10.686). Maleness was protective for medical complications (RR, 0.024; 95% CI, 0.005–0.126). Risk factors for surgical complications were obese class II (RR, 4.120; 95% CI, 1.123–15.120]), chronic obstructive pulmonary disease (COPD; RR, 21.981; 95% CI, 3.719–129.924), and inpatient surgery (RR, 8.606; 95% CI, 2.266–32.689). An independent functional status was protective against surgical complications (RR, 0.023; 95% CI, 0.002–0.221).Conclusions: Overall complication rates after distal biceps repair are quite low. Patient demographics (sex, age, BMI, and functional status), medical comorbidities (diabetes, smoking, and COPD), and surgical factors (inpatient versus outpatient surgery) were all predictive of various short-term complications.

scholarly journals Distal Biceps Tendon Repair Using A Single-incision Approach With Unicortical Intramedullary Button Fixation: Report Early Post-operative Outcomes And Complications

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0036
Author(s):  
Kenneth M. Lin ◽  
Justin Chan ◽  
Brian J. Lin ◽  
Christopher L. Camp ◽  
Grant Hoerig Garcia ◽  
...  
Keyword(s):  
Heterotopic Ossification ◽  
Single Incision ◽  
Biceps Tendon ◽  
Tendon Repair ◽  
Distal Biceps Tendon ◽  
Distal Biceps ◽  
Distal Biceps Repair ◽  
Cortical Button ◽  
Biceps Tendon Repair

Objectives: While various techniques for distal biceps repair have been described, biomechanical studies have shown cortical button fixation to outperform bone tunnels, intraosseous screws, and suture anchors. Furthermore, numerous studies have shown no difference in complication rate between single- and dual-incision approaches. Thus, it follows that a single-incision approach with cortical button fixation may provide superior clinical outcomes with minimal complications. The purpose of this study is first to investigate intra-operative and short-term complications of distal biceps tendon repair through a single-incision approach using unicortical button fixation, and secondly to assess clinical outcomes. Methods: 52 patients who underwent distal biceps repair with unicortical button fixation (Figure 1) at a single institution from 2014 to 2017 were identified. Exclusion criteria included age less than 18 or greater than 75 years, prior ipsilateral biceps repair, concomitant ipsilateral surgical procedure, and most recent follow-up less than 2 months. Postoperative nerve deficits, flexion and supination strength by manual testing, range of motion, Mayo Elbow Performance Score (MEPS) and radiographs for identification of heterotopic ossification (HO) were obtained and analyzed retrospectively. Results: Fifty-two patients with 53 distal biceps ruptures were included, with mean age 48 years (range 25-71 years). Median time from injury to surgery was 2 weeks (range 1 day to 16 weeks), with 15 patients being treated at greater than 3 weeks from injury. Forty-four patients (83%) had complete tears. Following surgery, average time to final follow-up was 22.8 weeks (range 8-65 weeks). Postoperatively, 49 patients (92.5%) had full range of motion, 48 patients (90.6%) had return of full supination and flexion strength by manual muscle testing (the remaining patients had strength graded as 5-/5). There was no difference in outcomes between those patients treated < 3 weeks from injury compared to those treated > 3 weeks from injury. Two patients (3.8%) initially reported sensory deficit in the lateral antebrachial cutaneous nerve distribution, both cases of which fully resolved by 7 and 11 weeks postoperative. Two patients (3.8%) displayed radiographic evidence of heterotopic ossification, Hastings and Graham class I (Figure 2). One of these was an incidental finding without any clinical symptoms, the other had mild pain but normal strength and neurovascular function. Mean postoperative MEPS was 93.9 (range 60-100), corresponding to “excellent” function (MEPS>90). Conclusion: Distal biceps repair using single incision, unicortical button fixation yields a low rate of complications with good clinical results compared to other techniques reported in the literature. The single incision approach in patients treated between 3 and 16 weeks from injury is safe and resulted in outcomes no different than in those patients treated <3 weeks from injury. Further investigation is warranted in the form of larger, comparative studies with more robust outcome measures and longer term follow up. [Figure: see text][Figure: see text]

scholarly journals Clinical Outcomes After Revision Distal Biceps Tendon Surgery

2021 ◽  
Vol 9 (1) ◽  
pp. 232596712098175
Author(s):  
Gagan Grewal ◽  
Eamon D. Bernardoni ◽  
Mark S. Cohen ◽  
John J. Fernandez ◽  
Nikhil N. Verma ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Revision Surgery ◽  
Single Incision ◽  
Biceps Tendon ◽  
Tendon Repair ◽  
Common Finding ◽  
Distal Biceps Tendon ◽  
Distal Biceps ◽  
Distal Biceps Repair ◽  
Biceps Tendon Repair

Background: Little is known about the clinical indications of performing a revision distal biceps tendon repair/reconstruction, and there is even less data available on the clinical outcomes of patients after revision surgery. Purpose: To determine the clinical outcomes of patients undergoing revision distal biceps tendon repair/reconstruction and evaluate the causes of primary repair failure. Study Design: Case series; Level of evidence, 4. Methods: We performed a retrospective review of patients undergoing ipsilateral primary and revision distal biceps tendon repair/reconstruction at a single institution. Between 2011 and 2016, a total of 277 patients underwent distal biceps tendon repair, with 8 patients requiring revision surgery. Patient characteristics, surgical technique, and patient-reported outcome scores (shortened version of Disabilities of Arm, Shoulder and Hand [QuickDASH], 12-Item Short Form Health Survey [SF-12], visual analog scale [VAS] for pain, and Mayo Elbow Performance Score [MEPS]), were assessed. Complications as well as indications for reoperation after primary and revision surgery were examined. Results: The overall revision rate was 2.9%. The number of single- and double-incision techniques utilized were similar among the primary repairs (50% single-incision, 50% double-incision) and revision repairs/reconstructions (62.5% single-incision, 37.5% double-incision). Reasons for reoperation included continued pain and weakness (n = 7), limited range of motion (n = 2), and acute traumatic re-rupture (n = 1). The median duration between primary and revision surgery was 9.5 months (interquartile range [IQR], 5.8-12.8 months). Intraoperatively, the most common finding during revision was a partially ruptured, fibrotic distal tendon with extensive adhesions. At a median of 33.7 months after revision surgery (IQR, 21.7-40.7 months), the median QuickDASH was 12.5 (IQR, 1.7-23.3), MEPS was 92.5 (IQR, 80.0-100), SF-12 mental component measure was 53.4 (IQR, 47.6-58.2), SF-12 physical component measure was 52.1 (IQR, 36.9-55.4), and VAS for elbow pain was 1.0 (IQR, 0-2.0). Revision surgery had a complication rate of 37.5% (3 of 8 patients), consisting of persistent pain and weakness (2 patients; 25%) and numbness over the dorsal radial sensory nerve (1 patient; 12.5%). Two patients required reoperation (25% reoperation rate). Conclusion: The overall revision distal biceps repair/reconstruction rate was approximately 3%. While patients undergoing revision distal biceps repair demonstrated improved outcomes after revision surgery, these outcomes remained inferior to previously reported outcomes of patients undergoing only primary distal biceps repair.

Return to Sport and Weightlifting Analysis Following Distal Biceps Tendon Repair

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

scholarly journals Fixation of Acute Distal Biceps Tendon Ruptures Using Mitek Anchors: A Retrospective Study

2014 ◽  
Vol 8 (1) ◽  
pp. 52-55 ◽  
Author(s):  
M. Al-Taher ◽  
Diederick B. Wouters
Keyword(s):  
Biceps Brachii ◽  
Biceps Tendon ◽  
Tendon Repair ◽  
Functional Results ◽  
Distal Biceps Tendon ◽  
Distal Biceps ◽  
Tendon Ruptures ◽  
Biceps Tendon Repair ◽  
Dash Questionnaire

Purpose of this Study: The aim of this study was to evaluate the outcomes of surgical intra-osseous fixation of the distal tendon of the ruptured biceps brachii muscle using Mitek anchors. Materials and Methods: Between 2005 and 2011, seven patients underwent unilateral distal biceps tendon repair using Mitek anchors. All patients were men aged between 36 and 47 years. Six patients were assessed by physical examination and use of the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Results: Surgery was performed within 3 to 17 days of rupture with a mean follow-up of 35 months. Of the six fully completed DASH questionnaires, three patients had a score of 0, and three patients had scores of 5.8, 10 and 10.8, respectively (10.1 is the mean score for the general population). Transient paraesthesias in the lateral antebrachial cutaneous nerve region occurred in two patients and one patient experienced a transient stiffness of the elbow due to scarring of the wound. No major complicatons have occurred. Conclusion: The use of Mitek anchors for the re-insertion of the ruptured distal biceps tendon proved to be a safe and effective technique with excellent functional results in our series.

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