Acute repair of distal biceps tendon rupture may have advantages vs. chronic repair
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Key takeaways:
- Single moderator analysis showed no differences in outcomes or complications between acute and chronic repairs.
- Multiple moderator analysis showed chronic repairs had a greater proportion of complications.
NEW ORLEANS — Results presented here showed acute repair of distal biceps tendon ruptures may result in better supination endurance, a lower proportion of complications and a lower rate of repeat surgery compared with chronic repair.
Cory A. Riccio, MD, and colleagues collected outcomes and complications in acute and chronic repairs for distal biceps tendon ruptures in systematically identified studies and used single and multiple moderator models to account for technical variations.
“The single moderator models contained a single moderator to evaluate acute vs. chronic. Since most of the studies didn’t substratify the results, we used our single moderator model to maximize our effect size,” Riccio said in his presentation at the Arthroscopy Association of North America Annual Meeting. “Then we used a multiple moderator model that contained an acute vs. chronic variable, and the additional variable was the approach in fixation.”
In the single moderator model, Riccio noted the acute repair group had greater flexion and supination endurance compared with the chronic repair group.
“While flexion endurance was greater, it didn’t reach statistical significance,” he said. “However, the supination endurance was significantly superior in the acute group. This advantage was not impacted by fixation technique or surgical approach.”
Although Riccio noted a slight trend toward higher arcs of motion in the acute repair group, he said both groups had no significant differences regarding range of motion and had postoperative range of motion values that were acceptable for day-to-day activities. He added the acute and chronic repair groups had no significant differences in patient-reported outcomes or complications.
“Consistent with previous reports, [heterotopic ossification] HO and sensory and nerve complications, which were most commonly reported, neither of these complications were significantly different between acute vs. chronic repairs, regardless of fixation technique or approach,” Riccio said.
In the multiple moderator analysis, Riccio noted patients in the acute repair group had significantly greater supination endurance regardless of fixation or approach.
“Chronic repairs were associated with a significantly greater proportion of complications, suggesting that acute repairs may result in lower overall rates of complications, regardless of approach or technique you’re using,” Riccio said. “Additionally, chronic repairs were associated with higher incidence of postoperative infection.”
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Riccio CA, et al. Acute vs. chronic repair for distal biceps tendon ruptures: A systematic review and meta-analysis. Presented at: Arthroscopy Association of North America Annual Meeting; May 4-6, 2023; New Orleans.
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