Repair of distal biceps brachii tendon assessed with 3-T magnetic resonance imaging and correlation with functional outcome

Abstract

The quality of functional outcome after anatomical elbow rehabilitation of DBT correlates with the extent of tendinous hypertrophy during the healing process.

Anatomy of the distal biceps tendon: an in vivo 3-T magnetic resonance imaging study

“…4,7,14 Fixation methods for anatomic repair include intraosseous Endo-Buttons, transosseous reinsertion suture anchors, interference screws, and transosseous sutures. 1,13,16 Given that our study has shown that the majority of DBTs exit the muscle belly as 2 discrete tendons and given that it appears that these tendons may have distinct insertions on the radial tuberosity to perform the 2 primary actions of the biceps, it is perhaps unsurprising that anatomic ''footprint'' repairs lead to better functional outcomes.…”

“…On the basis of the current literature, operative fixation of DBT tears is generally recommended given the potential for poor long-term functional outcomes in conservatively managed cases. 13 Nonanatomic repairs are now usually limited primarily to older patients and cases of delayed repair, 1 whereas anatomic repairs, using either intraosseous EndoButtons (Smith & Nephew Endoscopy, Andover, MA), transosseous reinsertion suture anchors, interference screws, or transosseous sutures, 1,13,16 have become standard.…”

“…The surgical management of DBT tears has been reported on extensively in the literature. Anatomic repairs, as opposed to nonanatomic repairs, which are now usually limited primarily to older patients and cases of delayed repair, 1 have become standard because anatomic repairs have repeatedly been shown to provide better functional outcomes in flexion and supination power. 4,7,14 Fixation methods for anatomic repair include intraosseous Endo-Buttons, transosseous reinsertion suture anchors, interference screws, and transosseous sutures.…”

Posttreatment Changes of the Elbow

“…Heterotopic ossifications are readily visualized on radiographs or by CT. To properly visualize the repaired distal biceps tendon directly, MRI is the best modality to exclude a tendon retear. 37 To achieve this goal, the elbow should be scanned in the so-called FABS position (i.e., elbow flexed, abducted, and supinated). 38 Moreover, peritendinous soft tissue abnormalities, such as postoperative bursitis, septic complications, or granulation tissue excess within the surgical tunnel, are all detectable by MRI ( Fig.…”