A Prospective Evaluation of Early Postoperative Complications After Distal Biceps Tendon Repairs

Abstract

Purpose The reported incidence of postoperative complications after distal biceps tendon repairs (DBTRs) has been determined largely by retrospective studies. We hypothesized that a large prospective cohort study of DBTRs would demonstrate increased complication rates relative to existing literature values. Secondarily, we hypothesized that most complications would be transient and self-limiting, regardless of the surgical technique employed for the repair.Methods Consecutive patients undergoing acute, primary DBTR from July 2016 to December 2017 were enrolled. The repair technique, postoperative protocol, and follow-up intervals were determined by the individual surgeons' protocols. Demographic information, surgical data, and complications were tabulated prospectively. Exclusion criteria included chronic DBTRs, secondary DBTRs requiring allograft, DBTRs of partial tears, and postoperative follow-up of less than 12 weeks. We included 212 repairs performed by 37 orthopedic surgeons in 3 different subspecialties.Results Sixty-five patients (30.7%) had 73 complications. Fifty patients (44.6%) in the 1-incision group experienced complications compared with 15 (15.0%) in the 2-incision group. Sixty patients (28.3%) developed a minor complication. Fifty-seven patients (26.9%) had sensory neurapraxias, 47 after a 1-incision procedure and 10 after a 2-incision procedure, a statistically significant difference. Of the patients with neurapraxias, 94.7% were resolved or improving at the time of the latest follow-up. Five patients (2.4%) developed a major complication, defined as a return to the operating room in the postoperative period due to deep infection or rerupture. ConclusionsThe complication rate after DBTR appears to be higher than 2 other retrospective studies and is predominantly in the form of transient neurapraxias. This study confirms that there is a higher complication rate in 1-incision techniques as compared with 2-incision techniques.

Clinical Result of Patients With Distal Biceps Tendon Rupture With Endobutton

“…In the study by Matzon et al, 15 the authors found that 2.4% of the operated cases presented complications that required new surgery due to tendon rupture or deep infection. Meanwhile, Samuel E. Ford et al 12 observed a reoperation rate of 4.5%.…”

Failure of the Interference Tenodesis Screw After Distal Bicep Tendon Repair With a Suture Button Technique: A Report of Two Cases

“…However, Kodde et al published a 2016 review suggesting fewer complications after a double-incision approach with bone tunnel fixation [ 1 , 6 ]. Lastly, a 2018 prospective study by Matzon et al reported early post-operative complications of 44.6% in a one-incision distal biceps repair cohort compared to 15% in a two-incision repair cohort [ 9 ]. Cumulatively, these findings illustrate that current evidence has yet to reach a consensus on surgical approach and fixation technique to provide optimal outcomes.…”

Distal biceps tendon repair: cost analysis of single- versus double-incision techniques in an ambulatory surgery center

“…6,10 Various methods of distal biceps repair have been the subject of extensive research, but currently there is no consensus on the clinical superiority of one approach or fixation method over the other. 1,3,8,[10][11][12]15 Historically, distal biceps repair was performed through an extensile anterior approach which carried a high risk of nerve complications. In the early 1960s, Boyd and Anderson published a two-incision technique to mitigate these risks, but encountered problems with limited forearm rotation due to synostosis related to subperiosteal dissection of the ulna.…”