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Distal biceps reconstruction yielded outcomes similar to primary repair
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NEW YORK — Treatment of chronic, irreparable distal biceps ruptures with distal biceps reconstruction with soft tissue allograft yielded similar failure rates, reoperation rates and final range of motion compared with primary repair, according to results presented at the American Shoulder and Elbow Surgeons Annual Meeting.
Benjamin A. Hendy, MD, and colleagues assessed reoperation, repair or reconstruction failure and final range of motion for 46 patients with chronic, irreparable distal biceps ruptures who underwent distal biceps reconstruction with soft tissue allograft. Results were compared with 92 patients who underwent primary repair matched for gender, procedure, BMI, age and Charlson Comorbidity Index.
“Average surgical delay for reconstruction with the allograft group was 116 days compared to 35 days in the direct repair group,” Hendy said in his presentation here.
Hendy noted one patient in the allograft group required revision reconstruction compared with three patients in the primary repair group. However, the groups had no significant differences with patient-reported outcome scores, according to Hendy. He added that there were good to excellent functional outcome scores in both groups.
“Elbow flexion and extension and forearm pronation and supination were similar between both groups at 12-week follow-up,” Hendy said. – by Casey Tingle
Reference:
Padegimas EM, et al. Paper 48. Presented at: American Shoulder and Elbow Surgeons Annual Meeting; Oct. 17-19, 2019; New York.
Disclosure: Hendy reports no relevant financial disclosures.
Perspective
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Felix H. Savoie, MD
This is an excellent study for three compelling reasons. The first is the fact that in both groups the success rate was high and the complication rate low. Many surgeons fear repairing the distal biceps due to reportedly high complication rates. The second is the excellent success rate obtained with primary repair. This is often thought to be the best option but does require expediency in getting the patient in for evaluation and surgery. The third point, and congratulations to Joseph Abboud, MD, and his colleagues for this excellent data, is that the more chronic tears can still be repaired/reconstructed with excellent chance of success.
This is a very good retrospective study with compelling data that should help our patients get the care they deserve.
Chair, department of orthopedic surgery
New Orleans
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