Distal Triceps Tendon Repair in Strength Athletes Leads to Satisfactory Return to Sports: A Retrospective Analysis of 22 Cases

Abstract

Background: Distal triceps brachii tendon rupture (DTTR) is a relatively rare injury that is common in bodybuilding and high-intensity contact sports and can lead to significant functional impairment of the elbow joint. This study was conducted to evaluate clinical outcomes and the rate of return to sports among competitive bodybuilders and high-demand strength athletes after surgical repair of DTTR. Methods: This retrospective case series was performed in an institutional setting in tertiary health care. Return to sports of 22 competing or high-demand strength athletes (meaning three or more exercises per week) were analyzed pre- and postoperatively after surgical repair of DTTR using a hybrid technique of transosseous sutures and anchor fixation. Descriptive statistics were used to analyze demographic variables, and independent and paired t-tests were used to assess clinical outcomes. Results: The follow-up showed that from pre- to postoperatively, there was no deterioration in the number of sports disciplines (2.4 and 2.5 sporting activities per person, respectively; p = 0.540) or in the frequency of weekly training (4.1 and 4.1 times per person, respectively; p = 0.329). The postoperative visual analog scale for pain (from 6.0 to 1.6, p < 0.001), level of fitness (from 5.1 to 2.6, p = 0.002), and ability to train (from 5.2 to 1.3, p < 0.001) improved significantly. The time of return to sports was 1.5-3 months and 4-6 months after the surgery for ten patients each. The overall rate of return to sports was 95%, whereas 86% returned to the preinjury level of sporting activity. Conclusions: Repair of DTTR leads to high rates of return to sports in competitive athletes.

Keywords: DTTR; chronic tendon injury; distal triceps repair; triceps reconstruction; triceps rupture.

Figure 1

Titanium or all-suture anchors in place with whipstitches used to fix the deep and the superficial tendon layer ((a) green sutures). Predrilled holes for transosseous sutures (in blue) to brace the superficial leaflet as a suture bridge (b). Reprinted with permission of Mathias Ritsch [23].

Figure 2

Frequency of exercises. The injury and the subsequent surgery did not have an effect on the number of training sessions per week. Presented as a percentage distribution of the population.

Figure 3

Variety of sporting activities. There was no difference between the two groups in regard to the five most common sporting activities. Presented as absolute values, n = 22.