Outpatient versus At-Home Physical Therapy Following Distal Biceps Repair.

Objectives: Distal biceps repair is a common orthopedic procedure, but there is still debate regarding the optimal post-operative care for patients. The purpose of this study is to assess the efficacy of at-home physical therapy compared to outpatient physical therapy following distal biceps tendon repair. Methods: A retrospective review of distal biceps repairs performed between 2012 and 2017 by four fellowship-trained orthopedic surgeons at one institution was undertaken. Patients were grouped into outpatient physical therapy and at-home therapy groups. Exclusion criteria included any patients who did not undergo a direct repair of the distal biceps and cases in which allograft augmentation was utilized. Postoperative complications were identified by manual chart review. After a minimum of three years follow-up, demographic information as well as elbow functional outcome scores including the Quick Dash, Mayo Elbow Performance Index, and Oxford Elbow Scores were obtained via phone calls and online surveys. Results: One hundred and forty-six patients were included in this study at a mean follow-up of 6.3 years for patients who attended outpatient physical therapy and 5.9 years for patients who performed an at-home therapy program. There were twenty-eight patients in the at-home physical therapy group and one hundred eighteen patients in the outpatient physical therapy group. There were two complications: one re-ruptured distal biceps tendon requiring a revision surgery in the at-home patient cohort, and one post-operative posterior interosseous nerve palsy that recovered after 6 months in the outpatient rehabilitation group. We found there was no significant difference between the two groups for any of the three functional elbow scores. Conclusion: Patients undergoing routine distal biceps repair may achieve similar clinical outcomes with a regimented at-home physical therapy protocol in lieu of formal outpatient physical therapy.