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.
Conclusions
The 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.
Type of study/level of evidence
Therapeutic II.
Key words
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Article info
Publication history
Published online: November 13, 2018
Accepted:
October 17,
2018
Received:
June 5,
2018
Footnotes
J. A. Abboud receives research support from Zimmer, Tornier, OREF, Arthrex, Orthospace, Integra, and DePuy Synthes; is the paid speaker for Tornier; receives royalties from Wolters Kluwer Health-Lippincott Williams and Wilkins, Integra, Cayenne, DJO, and Globus; is on the scientific advisory board of Mininvasive; is on the board of directors of Mid Atlantic Shoulder and Elbow Society; holds stock in Parvizi Surgical Innovation, OBERD, Marlin Medical Alliance, LLC, and Aevumed; is the consultant for Flexion; and is the co-founder of Shoulder JAM LLC.
Identification
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© 2019 by the American Society for Surgery of the Hand. All rights reserved.
