Top

MUSCULOSKELETAL SURGERY

Published in:

01-04-2015 | Original Article

Repair of distal biceps tendon acute ruptures with two suture anchors and anterior mini-open single incision technique: clinical follow-up and isokinetic evaluation

Authors: A. Gasparella, D. Katusic, A. Perissinotto, A. Miti

Published in: MUSCULOSKELETAL SURGERY | Issue 1/2015

Abstract

Background

All the techniques described in literature for treatment of acute distal biceps tendon ruptures provide good functional outcomes. The purpose of this study is to report the results of a single limited-incision technique for repair of acute distal biceps ruptures using two suture anchors.

Materials and methods

Fourteen patients, all man, were treated consecutively from one author between January 2009 and December 2011 and evaluated at a mean follow-up of 26 months. All patients were evaluated clinically, through DASH and MEPS score questionnaires, and with isokinetic biomechanical tests.

Results

All patients achieved complete elbow flexion and extension. Deficit for supination of the forearm was found in only two patients (7° and 13°). Mean DASH score was 4.7 points, and mean MEPS was excellent (96.8 points). There was no nervous complication involving posterior interosseous nerve (PIN) and no case of failure of the sutures. The isokinetic evaluation detected an average flexion strength increase by 10.2 % compared to the opposite arm not operated.

Conclusion

Our study shows that mini-open access and fixation with two suture anchors achieved in medium-term excellent functional and cosmetic results needed short rehabilitation times and is minimally invasive.

Wk Kelly, Steinmann S, O’Driscoll S (2003) Surgical treatment of partial distal biceps tendon ruptures through a single posterior incision. J Shoulder Elbow Surg 12:456–461CrossRef

Safran MR, Graham SM (2002) Distal biceps tendon ruptures: incidence, demographics, and the effect of smoking. Clin Orthop Relat Res 404:275–283CrossRefPubMed

Jockel CR, Mulieri PJ, Belsky MR, Leslie BM (2010) Distal biceps tendon tears in women. J Shoulder Elbow Surg 19(5):645–650CrossRefPubMed

Morgenthaler M, Weber M (1999) Pathological rupture of the distal biceps tendon after long-term androgen substitution. Z Orthop Ihre Grenzgeb 137:368–370CrossRefPubMed

Pagonis T, Givissis P, Ditsios K (2011) The effect of steroid-abuse on anatomic reinsertion of ruptured distal biceps brachii tendon. Injury 42(11):1307–1312CrossRefPubMed

O’Driscoll SW, Goncalves LB, Dietz P (2007) The hook test for distal biceps tendon avulsion. Am J Sports Med 35(11):1865–1869CrossRefPubMed

Ruland RT, Dunbar RP (2005) Bowen JD the biceps squeeze test for diagnosis of distal biceps tendon ruptures. Clin Orthop Relat Res 437:128–131CrossRefPubMed

Weiss C, Mittelmeier M, Gruber G (2000) Do we need MR images for diagnosing tendon ruptures of the distal biceps brachii? The value of ultrasonography imaging. Ultraschall Med 21(6):284–286CrossRefPubMed

Freeman CR, McCormick KR, Mahoney D, Baratz M, Lubahn J (2009) Nonoperative treatment of distal biceps tendon ruptures compared with a historical control group. J Bone Jt Surg Am 91:2329–2334CrossRef

10.

Chillemi C, Marinelli M, De Cupis V (2007) Rupture of the distal biceps brachii tendon: conservative treatment versus anatomic reinsertion–clinical and radiological evaluation after 2 years. Arch Orthop Trauma Surg 127(8):705–708 Epub 2007 Apr 28CrossRefPubMed

11.

Klonz A, Loitz D, Reilmann H (2003) Proximal and distal ruptures of the biceps brachii tendon. Unfallchirurg 106:755–763CrossRefPubMed

12.

Freeman CR, McCormick K, Mahoney D, Baratz M, Lubahn J (2009) Nonoperative treatment of distal Biceps tendon ruptures compared with a historical control group. J Bone Jt Surg 91:2329–2334CrossRef

13.

Boyd MM, Anderson LD (1961) A method for reinsertion of the distal biceps brachii tendon. J Bone Jt Surg 43A:1041–1043

14.

Keener JD (2011) Controversies in the surgical treatment of distal biceps tendon rupture: single versus double incision repairs. J Shoulder Elbow Surg 20(2Suppl):S113–S125CrossRefPubMed

15.

Grewal R, Athwal GS, Macdermid IC, Faber KJ, King GJ (2012) Single versus double-incision technique for the repair of acute distal biceps tendon ruptures: a randomized clinical trial. J Bone Jt Surg Am 94(13):1166–1174CrossRef

16.

Greenberg JA, Fernandez JJ, Wang T, Turner C (2003) Endobutton assisted repair of distal biceps tendon ruptures. J Shoulder Elbow Surg 12:484–490CrossRefPubMed

17.

Mazzocca AD, Burton KJ, Romeo AA, Santangelo S, Adams DA, Arciero RA (2007) Biomechanical evaluation of 4 techniques of distal biceps brachii tendon repair. Am J Sports Med 35(2):252–258CrossRefPubMed

18.

Rampoldi M, Cammarano G, De Peppo M, Piccioli A, Gentilucci F (2001) Rottura del tendine distale del bicipite brachiale: riparazione con ancorette in titanio, Riv Chir Mano, vol. 38(3)

19.

Morrison KD (2002) Hunt TR comparing and contrasting methods for tenodesis of the ruptured distal biceps tendon. Hand Clin 18(1):169–178CrossRefPubMed

20.

Klonz A, Loitz D, Reilmann H (2002) Technique of distal biceps tendon repair using a limited anterior approach. Unfallchirurg 105(9):837–842CrossRefPubMed

21.

Eames MH, Bain GI, Fogg QA, van Riet RP (2007) Distal biceps tendon anatomy: a cadaveric study. J Bone Jt Surg Am 89(5):1044–1049CrossRef

22.

Cho CH, Song KS, Choi IJ, Kim DK, Lee JH, Kim HT, Moon YS (2011) Insertional anatomy and clinical relevance of the distal biceps tendon. Knee Surg Sports Traumatol Arthrosc 19(11):1930–1935CrossRefPubMed

23.

Beaton DE, Katz JN, Fossel AH, Wright JG, Tarasuk V, Bombardier C (2001) Measuring the whole or the parts? Validity, reliability, and responsiveness of the disabilities of the arm, shoulder and hand outcome measure in different regions of the upper extremity. J Hand Ther 14(2):128–146CrossRefPubMed

24.

McKee MD, Hirji R, Schemitsch EH, Wild LM, Waddell JP (2005) Patient-oriented functional outcome after repair of distal biceps tendon ruptures using a single-incision technique. J Shoulder Elbow Surg 14(3):302–306CrossRefPubMed

25.

Cohen MS (2008) Complications of distal biceps tendon repairs. Sports Med Arthrosc 16:148–153CrossRefPubMed

26.

Richard A, Cain MD et al (2012) Complications following distal biceps repair. J Hand Surg 37A(10):2112–2117

27.

Silva J, Eskander M, Lareau C, De Angelis N (2010) Treatment of distal biceps tendon ruptures using a single-incision technique and bio-tenodesis screw. Orthopedics 33(7):477PubMed

28.

Kelly EW, Morrey BF, O’Driscoll SW (2000) Complications of repair of the distal biceps tendon with the modified two-incision technique. J Bone Jt Surg Am 82-A(11):1575–1581

29.

Gallinet D, Dietsch E, Barbier-Brion B, Lerais JM, Obert L (2011) Suture anchor reinsertion of distal biceps rupture: clinical results and radiological assessment of tendon healing. Orthop Traumatol Surg Res 97(3):252–259CrossRefPubMed

30.

John CK, Larry DF, Kenneth SW, Felix HS (2007) Single-incisione repair of acute distal biceps ruptures by use of suture anchors. J Shoulder Elbow Surg 16:78–83CrossRefPubMed

31.

Taylor CJ, Bansal R, Pimpalnerkar A (2003) Acute distal biceps tendon rupture-a new surgical technique using a de-tensioning suture to brachialis muscle. J Shoulder Elbow Surg 12:607–611CrossRef

32.

Mazzocca A, Cohen M, Berkson E, Nicholson G (2007) The anatomy of the bicipital tuberosity and distal biceps tendon. J Shoulder Elbow Surg 16:122–127CrossRefPubMed

33.

Jarret CD, Weir DM, Stuffmann ES, Jain S, Miller MC, Schmidt CC (2012) Anatomic and biomechanical analysis of the short and long head components of the distal biceps tendon. J Shoulder Elbow Surg 21(7):942–948CrossRef

34.

Bain GI, Johnson LJ, Turner PC (2008) Treatment of partial distal biceps tendon tears. Sports Med Arthrosc 16(3):154–161CrossRefPubMed

35.

Schmidt CC, Weir DM, Wong AS, Howard M, Miller MC (2010) The effect of biceps reattachment site. J Shoulder Elbow Surg 19(8):1157–1165CrossRefPubMed

36.

Lemos SE, Ebramzedeh E, Kvitne RS (2004) A new technique: in vitro suture anchor fixation ha superior yield strength to bone tunnel fixation for distal biceps tendon repair. Am J Sports Med 32:406–410CrossRefPubMed

37.

Weber O, Pagenstern G, Wirtz DC, Burger C, Wimmer M, Pennekamp PH, Gravius S, Muller M (2011) Refixation of distal biceps tendon rupture using 2 anchor sutures-sports ability after 1 year follow-up and operative technique. Sportverletz Sportschaden 25(2):97–192CrossRefPubMed

38.

Shukla DR, Morrey BF, Thoreson AR, An KN, O’Driscoll SW. Distal biceps tendon rupture: an in vitro study.Clin Biomech (Bristol, Avon). 2012 Mar;27(3):263-7. Epub 2011 Oct 24

39.

Sarda P, Qaddori A, Nauschutz F, Boulton L, Nanda R, Bayliss N (2013) Distal biceps tendon rupture: current concepts. Injury 44(4):417–420

40.

Moira W Devereaux, Amr W ElMaraghy (2013) Improving the rapid and reliable diagnosis of complete distal biceps tendon rupture: a nuanced approach to the clinical examination. Am J Sports Med 41(9)

41.

Banerjee M, Shafizadeh S, Bouillon B, Tjardes T, Wafaisade A, Balke M (2013) High complication rate following distal biceps refixation with cortical button. Arch Orthop Trauma Surg 133(10):1361–1366CrossRefPubMed

42.

Carità E, Cassini M, Ricci M, Corain M, Donatelli A, Cugola L (2009) Reinsertion of the distal head of the biceps using mini-anchors and the anterior access: a retrospective study. Musculoskelet Surg 93:21–25CrossRef

Title: Repair of distal biceps tendon acute ruptures with two suture anchors and anterior mini-open single incision technique: clinical follow-up and isokinetic evaluation
Authors: A. Gasparella
D. Katusic
A. Perissinotto
A. Miti
Publication date: 01-04-2015
Publisher: Springer Milan
Published in: MUSCULOSKELETAL SURGERY / Issue 1/2015
Print ISSN: 2035-5106
Electronic ISSN: 2035-5114
DOI: https://doi.org/10.1007/s12306-014-0314-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Repair of distal biceps tendon acute ruptures with two suture anchors and anterior mini-open single incision technique: clinical follow-up and isokinetic evaluation

Abstract

Background

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2015

Platelet-rich plasma: evidence for the treatment of patellar and Achilles tendinopathy—a systematic review

Patient-specific instrumentation for total knee arthroplasty: a literature review

Sliding external fixator “a product design and cadaveric experiment”

Evaluation of anterior knee pain in a PS total knee arthroplasty: the role of patella-friendly femoral component and patellar size

Osteoid osteoma of the phalanx and metacarpal bone: report of 17 cases

Erratum to: Evaluation of anterior knee pain in a PS total knee arthroplasty: the role of patella-friendly femoral component and patellar size