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Review
. 2022 Jan 5;10(1):23259671211065772.
doi: 10.1177/23259671211065772. eCollection 2022 Jan.

Surgical Results of Chronic Distal Biceps Ruptures: A Systematic Review

Arpun Bajwa  1 , Maciej J K Simon  2   3 , Jordan M Leith  2   4 , Farhad O Moola  2   5 , Thomas J Goetz  2 , Parth Lodhia  2   5
Affiliations
Review

Surgical Results of Chronic Distal Biceps Ruptures: A Systematic Review

Arpun Bajwa et al. Orthop J Sports Med. .

Abstract

Background: Distal biceps tendon tears can cause weakness and fatigue with activities requiring elbow flexion and supination. Surgical management of chronic tears (>21 days) is not well described in the literature.

Purpose: To determine the clinical outcomes of chronic distal biceps repairs and reconstructions.

Study design: Systematic review; Level of evidence, 4.

Methods: We performed a search of Medline (PubMed and Ovid), EMBASE, CINAHL physical therapy, Cochrane Database of Systematic Reviews and Central Register of Controlled Trials, and PubMed Central from inception until September 29, 2020, to identify articles on chronic distal biceps ruptures. The inclusion criteria were studies with at least 1 outcome measure and 10 patients with chronic distal biceps ruptures treated surgically. The quality of the included studies was assessed with the methodological index for nonrandomized studies (MINORS) score. Functional outcomes and complications were reviewed.

Results: A total of 12 studies were included after systematic database screenings. The MINORS scores ranged from 5 to 19. There were a total of 1704 distal biceps ruptures, of which 1270 were acute and 434 were chronic. Average follow-up time was 12 months to 5.1 years. Single-incision (n = 3), 2-incision (n = 2), or both (n = 6) surgical techniques were used in these studies. Four studies described the use of autografts, and 4 articles used allografts in the chronic repair. Range of motion, function, and strength outcomes were similar when compared with the contralateral arm. Pain was reduced to minimal levels. Main postoperative complications were of paresthesia (specifically to the lateral antebrachial cutaneous nerve), which were temporary in 69.1% of cases.

Conclusion: The results of this review indicate that surgical management of chronic distal biceps ruptures demonstrates improvement in outcomes including pain reduction and functional ability. Although there may be a slightly higher immediate complication rate, the functional outcomes remain comparable with those seen in the patient population with acute distal biceps.

Keywords: chronic distal biceps ruptures; clinical outcomes; reconstruction; repair; surgical management.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: J.M.L. has received teaching fees from Arthrex. T.J.G. has received teaching fees from Acumed and ConMed Linvatec. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
Search process in flow diagram using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.
See this image and copyright information in PMC

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