Comparison of functional and patient-reported outcomes following acute, chronic, and nonoperative distal biceps tendon rupture treatments.

Background: The purpose of this study was to compare functional outcomes of strength and endurance following 4 different treatment options for complete distal biceps tendon (DBT) ruptures: direct repair (DR), allograft reconstruction (AR), high-flexion angle repair (HFA), and non-operative management (NOP). Methods: A single-center retrospective chart review was performed on all patients with a DBT rupture. Sixty individuals at a minimum of 1-year postinjury participated in this study across the 4 groups: DR (n = 25), AR (n = 9), HFA (n = 11), and NOP (n = 15). Strength and endurance were measured on the injured and contralateral healthy arm using isokinetic dynamometry testing (Biodex Medical Systems, Inc) for forearm supination and elbow flexion. Patient-reported outcomes were collected through the Disabilities of the Arm, Shoulder, and Hand survey, and postsurgery satisfaction levels were collected through a proprietary survey. Results: There were significant differences in the injury to operation time between surgical groups; DR participants had significantly shorter times (13.8 days) than the HFA (74.9 days, Conclusion: Surgical repairs generally preserve functional strength, particularly in supination. Anatomic suspensory fixation repairs (DR and HFA) and nonoperative management may lead to reduced endurance capacity in the injured arm. Despite functional differences between the healthy and injured arm, operative and nonoperative treatment for DBT rupture can yield satisfactory outcomes, highlighting the need for prospective randomized trials to determine the optimal treatment for DBT ruptures.