Return to physical activity after the surgical treatment of distal biceps tendon tears

Abstract

Introduction. Distal biceps tendon tears remain relatively rare, representing 3% of all biceps injuries and having an incidence of 1.2 per 100,000. A distal biceps tendon tear is usually caused by an eccentric load to a flexed elbow and despite mostly affecting 40-50-year-old men, it also occurs in physically active patients at a younger age. Aim. The purpose of this study was to analyze whether physically active patients return to a pre-injury level of activity after the surgical reconstruction of distal biceps tendon tears. Materials and methods. The study included 20 patients treated surgically due to distal biceps tendon tears. The data from patients’ medical histories were analyzed. The post operative outcome and the level of physical activity was assessed using the Author’s Physical Activity Questionnaire (APAQ), Oxford Elbow Score (OES) and QuickDASH. A follow-up was conducted on average after 45.8 (±14.52) months. Results. All patients reported that they had returned to their pre-injury physical activity after surgery. Sixteen patients (80%) reached a pre-injury activity level, while 4 (20%) were unable to return to the same activity level. The reasons included fear of re-injury (n=4) and pain in the operated limb during physical activity (n = 2). The most common physical activities were: weightlifting (n = 11, 55%) and martial arts (n = 6, 30%). Patients before the injury undertook physical exercise 4.32 (±1.67) times a week, and post-injury 3.84 (±1.95) times a week (p = 0.035). The median time spent doing physical activity during the week decreased from 360 (IQR, 285-450) minutes pre-injury to 300 (IQR, 180-420) minutes post-surgery (p = 0.028). The patients started returning to training sessions on average 12.05 (±10.65) weeks after surgical treatment and a full return to physical activity was observed after 36 (±33.87) weeks. In the Oxford Elbow Score, the average score was 46.74 (±2.2), while the QuickDASH score was 1.58 (range, 0-6.8). Conclusions. The surgical treatment of a distal biceps tendon tear allows patients to return to physical activity in most cases.