BALTIMORE — Researchers found high complication rates associated with distal biceps tendon tears repaired with a single-incision technique, according to study results presented at the American Orthopaedic Society for Sports Medicine Annual Meeting 2012, here.
“Our overall complication rate was 58% with most common complication being transient sensory nerve dysfunction,” presenter Leslie Bisson, MD, said. “These tend to resolve in 6 to 9 months in all the patients we could verify and there is no association of complications with tourniquet use or hardware. Workers’ compensation, although it had a higher percentage of complications, was not statistically significant. We did find fewer complications when the surgery was performed within the first 2 weeks of injury.”
Bisson and colleagues studied 67 men who consecutively underwent distal biceps repairs using a single-incision anterior approach between 2003 and 2010. The average follow-up was 5 months and average patient age was 46 years. Twenty-nine patients had surgery within 2 weeks of injury, 22 patients underwent repair within 2 weeks to 6 weeks and 16 patients had surgery more than 6 weeks post- injury.
The investigators used the Chi squared test to compare complications by time to surgery, surgeon, hardware used, tourniquet use, and workers’ compensation cases.
They calculated a 58% complication rate, with transient nerve dysfunction, infection, loss of motion, rerupture or hardware problems among the complications noted. Among the seven workers’ compensation patients, there was an 86% complication rate, but this was not significant, Bisson said. The patients who underwent surgery within 2 weeks of injury showed lower complication rates than patients who underwent repair 2 weeks after injury. The tourniquet time, hardware type and longitudinal transverse incision were not significant factors of complications.
“Outcome studies of single-incision repairs have had complications ranging from 8% to 44% with the majority of these being sensory and nerve dysfunction,” Bisson said. “But there has been no study that has specifically focused on complications.”
Bisson L, Gawai YV, Fineberg MS, et al. Complications associated with single-incision distal biceps tendon repair. Paper #13. Presented at the American Orthopaedic Society for Sports Medicine Annual Meeting 2012. July 12-15. Baltimore.