Abstract
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.