Determining the incidence and risk factors for short-term complications following distal biceps tendon repair

Background: Distal biceps rupture is a relatively uncommon injury that can significantly affect quality of life. Surgical repair has the potential to provide functional improvement for patients. However, early complications following biceps tendon repair are not well described in the literature. This study aims to utilize a verified national surgical database to determine the incidence of and predictors for various short-term complications following distal biceps tendon repair. Methods: The American College of Surgeons’ National Surgical Quality Improvement Program database was used to identify patients undergoing distal biceps repair between January 1, 2011, and December 31, 2017. Patient demographic variables of sex, age, body mass index (BMI), American Society of Anesthesiologists class, functional status, and several comorbidities were reported for each patient, along with various 30-day postoperative complications. Binary logistic regression was used to calculate risk ratios for these complications using patient predictor variables.Results: Early postoperative overall surgical complications (0.5%)—which were mostly infections (0.4%)—and overall medical complications (0.3%) were rare. A risk factor for readmission was diabetes (risk ratio [RR], 4.238; 95% confidence interval [CI], 1.180–15.218). Risk factors for non-home discharge were smoking (RR, 3.006; 95% CI, 1.123–8.044) and 60 years of age (RR, 4.150; 95% CI, 1.611–10.686). Maleness was protective for medical complications (RR, 0.024; 95% CI, 0.005–0.126). Risk factors for surgical complications were obese class II (RR, 4.120; 95% CI, 1.123–15.120]), chronic obstructive pulmonary disease (COPD; RR, 21.981; 95% CI, 3.719–129.924), and inpatient surgery (RR, 8.606; 95% CI, 2.266–32.689). An independent functional status was protective against surgical complications (RR, 0.023; 95% CI, 0.002–0.221).Conclusions: Overall complication rates after distal biceps repair are quite low. Patient demographics (sex, age, BMI, and functional status), medical comorbidities (diabetes, smoking, and COPD), and surgical factors (inpatient versus outpatient surgery) were all predictive of various short-term complications.

Distal Biceps Repairs in Females: A Large Single-Center Case Series

Background: Distal biceps repair is a commonly reported procedure in male patients, with reliable outcomes and minimal long-term complications. Information on female patients, however, is limited, and variation in presentation and clinical outcomes is unknown. Questions/Purpose: We sought to report on the presentation, treatment algorithm, and outcomes of a case series of female patients with distal biceps pathology. Methods: A retrospective evaluation was performed from a large, single specialty orthopedic group from 2005 to 2017. Inclusion criteria were surgical treatment of the distal biceps in female patients, with minimum 3 months of follow-up. The primary outcome variable was the Mayo Elbow Performance Score (MEPS). Results: Of 26 patients who met inclusion criteria, 18 (70%) were available for follow-up with patient-reported outcomes. Median age at time of injury was 56.1 years; 46.2% of patients presented with a complete tear of the distal biceps, and the remaining 53.8% presented with a partial tear that failed nonoperative treatment. Six patients had lateral antebrachial cutaneous neuritis in early follow-up, which ultimately resolved. Median MEPS score was 100 (interquartile range: 20). Conclusion: This study represents the largest case series to date describing the presentation, treatment, and outcomes of female patients with distal biceps repair. Women tend to be older than men, have more insidious onset of pain, present with partial tearing, and may benefit from nonoperative treatment. Ultimately, based on this case series we believe distal biceps repair in female patients is a successful operation with minimal complications and high patient satisfaction.