scholarly journals Return to Work and Sport After Distal Biceps Repair

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0036
Author(s):  
Alexander Beletsky ◽  
Brandon J. Manderle ◽  
Joseph Liu ◽  
Benedict Uchenna Nwachukwu ◽  
Mark S. Cohen ◽  
...  
Keyword(s):  
Return To Work ◽  
Bench Press ◽  
Surgical Intervention ◽  
Return To Sport ◽  
Intensity Level ◽  
Heavy Duty ◽  
Postoperative Function ◽  
Distal Biceps ◽  
Distal Biceps Repair

Objectives: Outcomes following distal biceps repair are important to establish in order to properly counsel patients on expected postoperative function. Of particular interest are metrics regarding return to work and return to sport, including when return can be expected and at what intensity level. The purpose of this study is to establish important return to sport and work expectations for patients undergoing distal biceps repair. Methods: A prospectively maintained institutional database was retrospectively reviewed for all patients who underwent distal biceps repair since 2005 with minimum 24-month follow-up. A patient survey was conducted over phone with regard to preoperative and postoperative participation in sports, level of intensity, and maximum weight repetitions of barbell and dumbbell biceps curl, bench press, and consecutive push-ups. Results: A total of 49 patients (23 male) were contacted for final follow-up information. Average age was 54.38 + 13.49 and average time from initial injury to surgical intervention was 4.05 + 3.85 months. The dominant side was affected in 63.27% of cases. 32.65% of the injuries involve lifting of heavy objects, and 24.49% occurred during sport. Return to work was achieved in 85.71% of patients, occurring at an average of 1.41 months. Moderate and heavy duty status workers significantly differed from light and sedentary duty status patients in regard to average months to return to work (3.68 months vs. 0.53 months, P<0.001). 73.25% patients returned to the same or higher level of work. Return to sport was achieved by 89.80% of patients, and 44.89% returned to the same or higher intensity of sport. One-repetition maximum (ORM) an average of 15 pounds for barbell bench press and 27.5 pounds for dumbbell curls on the affected arm. Maximum consecutive pushups decreased by an average of 11.66. Time from injury to surgical intervention was found to be significantly associated with decreased push-up counts (P=0.019) and decreased days participating in sports per week (P=0.014) postoperatively. Conclusion: After surgical repair of distal biceps rupture, the majority of patients are able to return to work and sport. Those that work moderate and heavy duty status jobs tend to return at later dates, and patients with longer times to surgical invention have worse functional outcomes with respect to push-ups and frequency of sporting activities. These expected outcomes should be shared with patients to aid in decision making and communicate postsurgical expectations.

scholarly journals Return to Work and Sport Following Distal Triceps Repair

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0037
Author(s):  
Brandon Manderle ◽  
Evan Polce ◽  
Brady Williams ◽  
Gregory Nicholson ◽  
John Fernandez ◽  
...  
Keyword(s):  
Return To Work ◽  
Surgical Intervention ◽  
Nerve Repair ◽  
Return To Sport ◽  
Intensity Level ◽  
Postoperative Function ◽  
Distal Biceps ◽  
Distal Biceps Repair ◽  
Competitive Athletes

Objectives: Outcomes following distal triceps repair are important in order to properly counsel patients on expected postoperative function. Of particular interest are metrics regarding return to work and return to sport, including when return can be expected and at what intensity level. The purpose of this study is to establish important return to sport and work expectations for patients undergoing distal biceps repair. Methods: A prospectively maintained institutional database was retrospectively reviewed for all patients who underwent distal biceps repair since 2004 with minimum 2-year follow-up. A patient survey was conducted over phone with regard to preoperative and postoperative participation in sports, level of intensity, and maximum weight repetitions of barbell and dumbbell biceps curl, bench press, and consecutive push-ups. Mayo Elbow Performance Score (MEPS) and The Disabilities of the Arm, Shoulder and Hand Score (QuickDASH) were collected preoperatively and at final follow up. T-tests and chi-squared analysis was used to examine continous and categorical outcome variables, respectively. Results: A total of 70 patients (41 male) were contacted for final follow-up information. Average age was 48.42 + 13.32 and average time from initial injury to surgical intervention was 3.12 + 2.88 months. 81% of the injuries involve lifting of heavy objects, and 27.7% occurred during sport. Ten percent (n=7) of patients returned to the operating room, most commonly for ulnar nerve repair. Return to work was achieved in 86.3% of patients, occurring at an average of 2.87 months. Heavy duty status workers returned at significantly later time points than sedentary or light duty status workers (5.35 vs. 1.21 months, p<0.01). 81.4% of patients returned to the same or higher level of work. Return to sport was achieved by 79.7% of patients at an average of 3.32 months. 73.9% of patients were either satisfied or very satisfied with their ability to work, and 68.6% were satisfied or very satisfied with their ability to play spots. All competitive athletes (n=11) returned to either the same or higher level of intensity following surgery. Conclusion: Surgical repair of a distal triceps injury results in reliable return to work and sport, with the majority of patients returning to the same physical intensity of work and the same intensity of sporting, respectively. Competitive athletes demonstrate particularly impressive results with heightened return to sport rates at the same or greater intensity level, suggesting motivation level may have a role in determining successful return to sport. Our data may be utilized to better inform the shared decision-making process between providers and patients when considering surgical intervention for distal triceps injuries.

scholarly journals Return of an Intact Hook Test Result: Clinical Assessment of Biceps Tendon Integrity After Surgical Repair

2019 ◽  
Vol 7 (2) ◽  
pp. 232596711982731 ◽  
Author(s):  
Graham D. Pallante ◽  
Shawn W. O’Driscoll
Keyword(s):  
Surgical Repair ◽  
Biceps Tendon ◽  
Distal Biceps Tendon ◽  
Level Of Evidence ◽  
Distal Biceps ◽  
Effective Manner ◽  
Distal Biceps Repair ◽  
Tendon Ruptures ◽  
Test Result

Background: The hook test is a sensitive and specific tool that has been previously described for diagnosing distal biceps tendon ruptures in an efficient, cost-effective manner. However, its application in postoperative evaluations after surgical repair of distal biceps tendon ruptures is not documented. Hypothesis/Purpose: We hypothesized that the hook test result returns to normal at some point postoperatively after distal biceps repair. This information could be used in decision making during follow-up examinations with both normal and abnormal findings. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: We retrospectively reviewed records of distal biceps repair. Between July 1, 2003, and July 1, 2016, a total of 56 patients underwent distal biceps repair and also had clear documentation of the results of the hook test during the postoperative period. Hook test results consisted of “intact,” “abnormal,” or “absent.” The timing of the return to a normal hook test result was recorded. Results: Overall, 51 of 57 (89%) repairs were documented to have the hook test result return to “intact.” The test result returned to intact by a mean of 10 weeks after surgery (range, 2 weeks to 15 months). The biceps tendon was intact according to the hook test at the 4-month follow-up in 45 of the 51 patients (88%) in whom it ultimately returned. The hook test result was abnormal in 5 repairs in 5 patients with only a short-term follow-up, ranging from 2 to 7 weeks postoperatively. One patient with an abnormal hook test result at 2 weeks postoperatively underwent revision and was confirmed to have a partial tear of the biceps insertion. His hook test result returned to intact 3 months after revision repair. Conclusion: The hook test result returns to normal in patients who undergo distal biceps repair in the primary and revision settings with adequate follow-up. The vast majority of patients have a normal hook test result by 4 months postoperatively. An abnormal hook test result at 4 months postoperatively may indicate a failed repair and should prompt further investigation.

scholarly journals Superior Capsular Reconstruction Patients Have High Rates of Return to Sports and Similar Functional Outcomes Compared to a Reverse Shoulder Arthroplasty Matched Cohort

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0027
Author(s):  
Brandon C. Cabarcas ◽  
Grant Hoerig Garcia ◽  
Joseph Liu ◽  
Gregory Louis Cvetanovich ◽  
Anirudh K. Gowd ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Return To Work ◽  
Functional Outcomes ◽  
Return To Sport ◽  
Postoperative Outcome ◽  
Rotator Cuff Tears ◽  
Return To Sports ◽  
Superior Capsular Reconstruction ◽  
One Year

Objectives: Superior capsular reconstruction (SCR) is a relatively new procedure to address irreparable rotator cuff tears and rotator cuff arthropathy. Biomechanical studies have produced favorable results on cadaveric models, but few studies have evaluated clinical outcomes, and none have addressed return to sport (RTS). The purpose of this study was to evaluate rates of RTS and functional outcomes after SCR compared to a reverse total shoulder arthroplasty (rTSA) matched cohort. Methods: A prospectively collected registry was queried retrospectively for consecutive patients who underwent SCR from 2015 to 2016. Inclusion criteria were ≥2 tendon irreparable rotator cuff tear by arthroscopic evaluation and minimum one-year follow up. All eligible SCR patients were matched by gender, age, handedness, and follow up time to patients that underwent rTSA with a similar preoperative diagnosis. All surgeries were performed by a single surgeon at one institution with consistent operative techniques. Patients were evaluated with the ASES questionnaire, VAS Pain Scale, as well as VR/SF-12 and VR6D. Patients were also administered a detailed outcomes survey regarding surgical history and return to sport and work activities. Results: Overall 75.0% of 32 eligible patients were available at follow up. Average age at surgery and follow up did not significantly differ between cohorts (p>0.500 both). Postoperative outcome scores for ASES, VAS, VR/SF-12, and VR6D did not differ (p>0.310 for all) between cohorts. Overall RTS rate was 77.8% for SCR and 87.5% for rTSA (p > 0.610). Average months to return to sports was significantly greater after SCR (7.3 ± 3.0) compared to rTSA (3.5 ± 2.2; p = 0.032). Patients in both cohorts participated in golf, weight-lifting, gym activity, basketball and cycling postoperatively. Direct RTS for these sports are displayed in Fig. 1. Return to work rate was 71.4% (10/14) SCR and 50.0% (4/8) rTSA (p = 0.326) at average 2.7 ± 2.8 and 1.9 ± 1.9 months, respectively (p = 0.591). Stratified by duty status, rates of return to work were sedentary (100% both SCR and rTSA), light (100% both SCR and rTSA), moderate (0% SCR and 66.67% rTSA), and heavy (0% both SCR and rTSA). Overall, 85.71% SCR patients and 90.0% rTSA patients were satisfied or very satisfied with their general postoperative outcome. Conclusion: At short-term follow-up, SCR patients had RTS rates comparable to rTSA patients with irreparable rotator cuff tears. However, time to RTS was more prolonged after SCR. Outcome scores did not significantly differ between the two cohorts, suggesting that SCR may achieve postoperative function and pain reduction similar to rTSA at one year. Return to work was also similar, although rates were not as high as return to sport. When stratified by duty status, return to more intense physical work demands was not consistent in either cohort. Despite this, over 85% of SCR and rTSA patients were satisfied postoperatively. The findings of this study demonstrate that SCR patients have high RTS levels, as well as similar functional outcomes and satisfaction compared to rTSA for irreparable rotator cuff tears. Clinicians can utilize this information for preoperative counseling, particularly with younger more athletic patients, considering SCR or rTSA for an irreparable rotator cuff tear.

Return to work following a distal biceps repair: a systematic review of the literature

2020 ◽  
Vol 29 (5) ◽  
pp. 1002-1009 ◽  
Author(s):  
Luc Rubinger ◽  
Max Solow ◽  
Herman Johal ◽  
Jamal Al-Asiri
Keyword(s):  
Systematic Review ◽  
Return To Work ◽  
Review Of The Literature ◽  
Distal Biceps ◽  
Distal Biceps Repair

scholarly journals Distal Biceps Tendon Repair Using A Single-incision Approach With Unicortical Intramedullary Button Fixation: Report Early Post-operative Outcomes And Complications

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0036
Author(s):  
Kenneth M. Lin ◽  
Justin Chan ◽  
Brian J. Lin ◽  
Christopher L. Camp ◽  
Grant Hoerig Garcia ◽  
...  
Keyword(s):  
Heterotopic Ossification ◽  
Single Incision ◽  
Biceps Tendon ◽  
Tendon Repair ◽  
Distal Biceps Tendon ◽  
Distal Biceps ◽  
Distal Biceps Repair ◽  
Cortical Button ◽  
Biceps Tendon Repair

Objectives: While various techniques for distal biceps repair have been described, biomechanical studies have shown cortical button fixation to outperform bone tunnels, intraosseous screws, and suture anchors. Furthermore, numerous studies have shown no difference in complication rate between single- and dual-incision approaches. Thus, it follows that a single-incision approach with cortical button fixation may provide superior clinical outcomes with minimal complications. The purpose of this study is first to investigate intra-operative and short-term complications of distal biceps tendon repair through a single-incision approach using unicortical button fixation, and secondly to assess clinical outcomes. Methods: 52 patients who underwent distal biceps repair with unicortical button fixation (Figure 1) at a single institution from 2014 to 2017 were identified. Exclusion criteria included age less than 18 or greater than 75 years, prior ipsilateral biceps repair, concomitant ipsilateral surgical procedure, and most recent follow-up less than 2 months. Postoperative nerve deficits, flexion and supination strength by manual testing, range of motion, Mayo Elbow Performance Score (MEPS) and radiographs for identification of heterotopic ossification (HO) were obtained and analyzed retrospectively. Results: Fifty-two patients with 53 distal biceps ruptures were included, with mean age 48 years (range 25-71 years). Median time from injury to surgery was 2 weeks (range 1 day to 16 weeks), with 15 patients being treated at greater than 3 weeks from injury. Forty-four patients (83%) had complete tears. Following surgery, average time to final follow-up was 22.8 weeks (range 8-65 weeks). Postoperatively, 49 patients (92.5%) had full range of motion, 48 patients (90.6%) had return of full supination and flexion strength by manual muscle testing (the remaining patients had strength graded as 5-/5). There was no difference in outcomes between those patients treated < 3 weeks from injury compared to those treated > 3 weeks from injury. Two patients (3.8%) initially reported sensory deficit in the lateral antebrachial cutaneous nerve distribution, both cases of which fully resolved by 7 and 11 weeks postoperative. Two patients (3.8%) displayed radiographic evidence of heterotopic ossification, Hastings and Graham class I (Figure 2). One of these was an incidental finding without any clinical symptoms, the other had mild pain but normal strength and neurovascular function. Mean postoperative MEPS was 93.9 (range 60-100), corresponding to “excellent” function (MEPS>90). Conclusion: Distal biceps repair using single incision, unicortical button fixation yields a low rate of complications with good clinical results compared to other techniques reported in the literature. The single incision approach in patients treated between 3 and 16 weeks from injury is safe and resulted in outcomes no different than in those patients treated <3 weeks from injury. Further investigation is warranted in the form of larger, comparative studies with more robust outcome measures and longer term follow up. [Figure: see text][Figure: see text]

Analysis of Return to Sport and Weight Training After Repair of the Pectoralis Major Tendon

2019 ◽  
Vol 47 (9) ◽  
pp. 2151-2157 ◽  
Author(s):  
Joseph N. Liu ◽  
Anirudh K. Gowd ◽  
Grant H. Garcia ◽  
Brandon J. Manderle ◽  
Alexander Beletsky ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Bench Press ◽  
Case Series ◽  
Return To Sport ◽  
Pectoralis Major ◽  
Functional Score ◽  
Repetition Maximum ◽  
Number Of Patients ◽  
Patient Reported

Background: The use of routine patient-reported outcomes after repair of the pectoralis major tendon (PMT) is often prone to the ceiling effect owing to the high functional demand of those who sustain this injury. Hypothesis: A significant number of patients are expected to fail to achieve return to preoperative activity after PMT repair despite achieving significant improvements in functional score. Study Design: Case series; Level of evidence, 4. Methods: A prospectively maintained institutional database was reviewed for all patients undergoing PMT repair from 2010 to 2016. Patients were surveyed with regard to pre- and postoperative participation in sports, level of intensity, maximum weight repetitions in exercises utilizing the PMT, and American Shoulder and Elbow Surgeons (ASES) and Single Assessment Numeric Evaluation (SANE) scores. Results: Forty-four patients (73.3%) were available for final follow-up. All patients were male. Mean ± SD follow-up was 51.1 ± 24.1 months. Mean age was 39.6 ± 8.8 years (range, 24-61 years), and mean body mass index was 28.6 ± 3.5 kg/m2. The dominant side was affected in 20 of 44 cases. Acute repairs were performed in 30 cases and chronic in 14. There were statistically significant improvements in both ASES and SANE scores ( P < .001). Return to sport at any level was achieved by 43 of 44 (97.7%) patients, while 22 of 44 patients (50.0%) reported returning to sport at the same or better intensity as preinjury status. On average, there was a 23.3% ± 45.6% decrease in 1–repetition maximum (1RM) barbell bench press, 14.7% ± 62.3% decrease in 5–repetition maximum barbell bench press, 24.3% ± 21.8% decrease in 1RM dumbbell bench press, 35.7% ± 32.1% decrease in 1RM dumbbell fly, and 15.6% ± 39.8% decrease in consecutive push-ups able to be performed. Seventeen patients (38.6%) reported a degree of apprehension that affected their ability to lift weights. When all preoperative variables were accounted for, history of surgery to the contralateral shoulder (odds ratio, 0.600; 95% CI, 0.389-0.925) was associated with a decreased likelihood of returning to sport at the same or better level of intensity, while injury sustained during sport had a greater likelihood (odds ratio, 2.231; 95% CI, 1.234-4.031). Conclusion: Patients undergoing PMT repair should expect significant functional improvements and a low complication rate. Yet, only 50% are able to return to preoperative intensity of sport, and they will also have significant reductions in their ability to weight lift.

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

2021 ◽  
pp. 155633162110098
Author(s):  
Allison J. Rao ◽  
Gregory T. Scarola ◽  
Taylor M. Rowe ◽  
Nicholas C. Yeatts ◽  
David M. Macknet ◽  
...  
Keyword(s):  
Treatment Algorithm ◽  
Case Series ◽  
Nonoperative Treatment ◽  
Outcome Variable ◽  
Inclusion Criteria ◽  
Female Patients ◽  
Distal Biceps ◽  
Distal Biceps Repair ◽  
Patient Reported

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.

Mini-open incision for distal biceps repair by suture anchors: follow-up of eighteen patients

2015 ◽  
Vol 100 (1) ◽  
pp. 19-23 ◽  
Author(s):  
L. Pangallo ◽  
A. Valore ◽  
L. Padovani ◽  
G. Coratella ◽  
F. Schena ◽  
...  
Keyword(s):  
Suture Anchors ◽  
Distal Biceps ◽  
Distal Biceps Repair ◽  
Mini Open

scholarly journals Outcomes following surgical management of inguinal-related groin pain in athletes: a case series

2020 ◽  
Vol 7 (1) ◽  
pp. 103-108
Author(s):  
Michael Gerhardt ◽  
Josh Christiansen ◽  
Benjamin Sherman ◽  
Alejandro Miranda ◽  
William Hutchinson ◽  
...  
Keyword(s):  
Groin Pain ◽  
Surgical Intervention ◽  
Case Series ◽  
Return To Sport ◽  
Scar Tissue ◽  
Nerve Entrapment ◽  
Return To Play ◽  
Retrospective Case ◽  
Operative Findings

Abstract To determine the outcomes of a limited surgical intervention, consisting of neurolysis, inguinal wall repair and/or adductor debridement of adhesions based on intraoperative findings. Retrospective case series. Outpatient orthopedic/general surgery clinic. Fifty-one athletes treated surgically for inguinal-related groin pain from 2009 to 2015. Limited surgical intervention, consisting of neurolysis, inguinal wall repair and/or adductor debridement based on intra-operative findings. Ability to return to sport at the same level, time to return to play. Fifty-one athletes were included in the study with an average follow-up of 4.42 years (range 2.02–7.01). The average age was 24.2 years (range 16–49) and consisted of 94.0% males and 6.0% females. Nerve entrapment was demonstrated in 96.2% of cases with involvement of the ilioinguinal in 92.5%, the iliohypogastric in 30.8% and the genitofemoral in 13.2%. Attenuation of the posterior inguinal wall was present and repaired in 79.3% of cases. Scar tissue was present around the adductor origin and required debridement in 56.7% of cases. Forty-nine (96.1%) athletes returned to sport at the same level of play at an average of 5.9 weeks. Two athletes required a revision surgery. High rates of return to sport were achieved after surgery for inguinal-related groin pain that addresses the varying pathology and associated nerve entrapment.

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