Single-incision chronic distal biceps tendon repair with tibialis anterior allograft
Michael B Cross, Claus Christoph Egidy, Ray H Wu, Daryl C Osbahr, Denis Nam & Joshua S Dines
abstract
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PURPOSE
Several techniques for chronic distal biceps tendon repair have been
reported; however, the literature is sparse.
METHODS
Seven male patients who underwent chronic distal biceps tendon
reconstruction were retrospectively evaluated. All patients had
significant retraction necessitating the use of an allograft for
reconstruction. The procedure was done through a single incision
using suture anchors and a tibialis anterior allograft. In each
case, the graft was first fixed to the radial tuberosity with suture
anchors, and then the allograft was sutured to the remnant of the
native biceps tendon at 60° of elbow flexion. Patients were
evaluated with the Mayo Elbow Performance Score (MEPS), Disabilities
of Arm, Shoulder and Hand (DASH) scores and elbow range of motion
(ROM).
RESULTS
The average time from injury to surgery was 25 (12-56) weeks, and
the average follow-up was 16 (minimum 12) months. Average
postoperative elbow ROM was as follows: extension 4°
(0-12°), flexion 134° (130-140°), pronation 82°
(75-85°) and supination 80° (70-85°); average MEPS was
94 (80-100); average DASH score was 6.67 (0-19.8). One patient
developed a lateral antebrachial cutaneous neuritis postoperatively
that resolved by three months.
CONCLUSION
Though many reported techniques for chronic distal biceps tendon
repair achieve satisfactory outcomes with limited complications, we
present a technique with theoretical advantages of a single
incision, use of suture anchors, use of a tibialis anterior
allograft and tensioning after attachment of the graft to the radial
tuberosity. In a series of complicated patients, early results were
good to excellent.
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citation
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Cross M B, Egidy C C, Wu R H, Osbahr D C, Nam D, Dines J S.
Single-incision chronic distal biceps tendon repair with tibialis
anterior allograft. Int Orthop 2013; 38:791-5.
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type
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journal paper/review (English)
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date of publishing
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24-11-2013
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journal title
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Int Orthop (38/4)
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ISSN electronic
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1432-5195
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pages
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791-5
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PubMed
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24271333
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DOI
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10.1007/s00264-013-2182-0
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