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

  • Goedderz, Cody (Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine) ;
  • Plantz, Mark A. (Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine) ;
  • Gerlach, Erik B. (Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine) ;
  • Arpey, Nicholas C. (Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine) ;
  • Swiatek, Peter R. (Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine) ;
  • Cantrell, Colin K. (Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine) ;
  • Terry, Michael A. (Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine) ;
  • Tjong, Vehniah K. (Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine)
  • Received : 2021.09.05
  • Accepted : 2021.12.20
  • Published : 2022.03.01

Abstract

Background: Distal biceps rupture is a relatively uncommon injury that can significantly affect quality of life. Early complications following biceps tendon repair are not well described in the literature. This study utilizes a national surgical database to determine the incidence of and predictors for 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, American Society of Anesthesiologists class, functional status, and several comorbidities were collected for each patient, along with 30-day postoperative complications. Binary logistic regression was used to calculate risk ratios for these complications using patient predictor variables. Results: Early postoperative surgical complications (0.5%)-which were mostly infections (0.4%)-and medical complications (0.3%) were rare. A readmission risk factor was diabetes (risk ratio [RR], 4.238; 95% confidence interval [CI], 1.180-15.218). Non-home discharge risk factors 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). Surgical complication risk factors 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). Conclusions: Complication rates after distal biceps repair are low. Various patient demographics, medical comorbidities, and surgical factors were all predictive of short-term complications.

Keywords

References

  1. Quach T, Jazayeri R, Sherman OH, Rosen JE. Distal biceps tendon injuries: current treatment options. Bull NYU Hosp Jt Dis 2010;68:103-11.
  2. Kelly MP, Perkinson SG, Ablove RH, Tueting JL. Distal biceps tendon ruptures: an epidemiological analysis using a large population database. Am J Sports Med 2015;43:2012-7. https://doi.org/10.1177/0363546515587738
  3. Safran MR, Graham SM. Distal biceps tendon ruptures: incidence, demographics, and the effect of smoking. Clin Orthop Relat Res 2002;(404):275-83.
  4. Freeman CR, McCormick KR, Mahoney D, Baratz M, Lubahn JD. Nonoperative treatment of distal biceps tendon ruptures compared with a historical control group. J Bone Joint Surg Am 2009;91:2329-34. https://doi.org/10.2106/JBJS.H.01150
  5. Legg AJ, Stevens R, Oakes NO, Shahane SA. A comparison of nonoperative vs. Endobutton repair of distal biceps ruptures. J Shoulder Elbow Surg 2016;25:341-8. https://doi.org/10.1016/j.jse.2015.10.008
  6. Shields E, Olsen JR, Williams RB, Rouse L, Maloney M, Voloshin I. Distal biceps brachii tendon repairs: a single-incision technique using a cortical button with interference screw versus a double-incision technique using suture fixation through bone tunnels. Am J Sports Med 2015;43:1072-6. https://doi.org/10.1177/0363546515570465
  7. Waterman BR, Navarro-Figueroa L, Owens BD. Primary repair of traumatic distal biceps ruptures in a military population: clinical outcomes of single- versus 2-incision technique. Arthroscopy 2017;33:1672-8. https://doi.org/10.1016/j.arthro.2017.02.008
  8. Amarasooriya M, Bain GI, Roper T, Bryant K, Iqbal K, Phadnis J. Complications after distal biceps tendon repair: a systematic review. Am J Sports Med 2020;48:3103-11. https://doi.org/10.1177/0363546519899933
  9. Beks RB, Claessen FM, Oh LS, Ring D, Chen NC. Factors associated with adverse events after distal biceps tendon repair or reconstruction. J Shoulder Elbow Surg 2016;25:1229-34. https://doi.org/10.1016/j.jse.2016.02.032
  10. Kannus P, Jozsa L. Histopathological changes preceding spontaneous rupture of a tendon: a controlled study of 891 patients. J Bone Joint Surg Am 1991;73:1507-25. https://doi.org/10.2106/00004623-199173100-00009
  11. Shiloach M, Frencher SK Jr, Steeger JE, et al. Toward robust information: data quality and inter-rater reliability in the American College of Surgeons National Surgical Quality Improvement Program. J Am Coll Surg 2010;210:6-16. https://doi.org/10.1016/j.jamcollsurg.2009.09.031
  12. Plantz MA, Hsu WK. Single-level posterolateral fusion (PLF) alone and posterior interbody fusion (PLIF/TLIF) alone lead to a decreased risk of short-term complications compared to combined PLF with PLIF/TLIF procedures: a matched analysis. Spine (Phila Pa 1976) 2020;45:E1391-9.
  13. Sherman AE, Plantz MA, Hardt KD. Outcomes of elective total hip arthroplasty in nonagenarians and centenarians. J Arthroplasty 2020;35:2149-54. https://doi.org/10.1016/j.arth.2020.03.026
  14. McCarthy MH, Singh P, Nayak R, et al. Can the American College of Surgeons risk calculator predict 30-day complications after spine surgery. Spine (Phila Pa 1976) 2020;45:621-8. https://doi.org/10.1097/BRS.0000000000003340
  15. Ford SE, Andersen JS, Macknet DM, Connor PM, Loeffler BJ, Gaston RG. Major complications after distal biceps tendon repairs: retrospective cohort analysis of 970 cases. J Shoulder Elbow Surg 2018;27:1898-906. https://doi.org/10.1016/j.jse.2018.06.028
  16. Casadei K, Kiel J, Freidl M. Triceps tendon injuries. Curr Sports Med Rep 2020;19:367-72. https://doi.org/10.1249/jsr.0000000000000749
  17. Nelson GN, Wu T, Galatz LM, Yamaguchi K, Keener JD. Elbow arthroscopy: early complications and associated risk factors. J Shoulder Elbow Surg 2014;23:273-8. https://doi.org/10.1016/j.jse.2013.09.026
  18. Waterman BR, Dean RS, Veera S, et al. Surgical repair of distal triceps tendon injuries: short-term to midterm clinical outcomes and risk factors for perioperative complications. Orthop J Sports Med 2019;7:2325967119839998.
  19. Fox AJ, Bedi A, Deng XH, et al. Diabetes mellitus alters the mechanical properties of the native tendon in an experimental rat model. J Orthop Res 2011;29:880-5. https://doi.org/10.1002/jor.21327
  20. Batista F, Nery C, Pinzur M, et al. Achilles tendinopathy in diabetes mellitus. Foot Ankle Int 2008;29:498-501. https://doi.org/10.3113/fai-2008-0498
  21. Gronkjaer M, Eliasen M, Skov-Ettrup LS, et al. Preoperative smoking status and postoperative complications: a systematic review and meta-analysis. Ann Surg 2014;259:52-71. https://doi.org/10.1097/sla.0b013e3182911913
  22. Seiler JG 3rd, Parker LM, Chamberland PD, Sherbourne GM, Carpenter WA. The distal biceps tendon: two potential mechanisms involved in its rupture: arterial supply and mechanical impingement. J Shoulder Elbow Surg 1995;4:149-56. https://doi.org/10.1016/S1058-2746(05)80044-8
  23. DelBuono A, Battery L, Denaro V, Maccauro G, Maffulli N. Tendinopathy and inflammation: some truths. Int J Immunopathol Pharmacol 2011;24(1 Suppl 2):45-50
  24. Sheils CR, Dahlke AR, Kreutzer L, Bilimoria KY, Yang AD. Evaluation of hospitals participating in the American College of Surgeons national surgical quality improvement program. Surgery 2016;160:1182-8. https://doi.org/10.1016/j.surg.2016.04.034