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Orthop J Sports Med. 2019 Apr 30;7(4):2325967119839998. doi: 10.1177/2325967119839998. eCollection 2019 Apr.

Surgical Repair of Distal Triceps Tendon Injuries: Short-term to Midterm Clinical Outcomes and Risk Factors for Perioperative Complications.

Author information

1
Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
2
University of Illinois College of Medicine, Chicago, Illinois, USA.
3
Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, USA.
4
Rothman Orthopaedic Institute, New York City, New York, USA.

Abstract

Background:

Few large-scale series have described functional outcomes after distal triceps tendon repair. Predictors for operative success and a comparative analysis of surgical techniques are limited in the reported literature.

Purpose:

To evaluate short-term to midterm functional outcomes after distal triceps tendon repair in a broad patient population and to comparatively evaluate patient-reported outcomes in patients with and without pre-existing olecranon enthesopathy while also assessing for modifiable risk factors associated with adverse patient outcomes and/or revision surgery.

Study Design:

Case series; Level of evidence, 4.

Methods:

This study was a retrospective analysis of 69 consecutive patients who underwent surgical repair of distal triceps tendon injuries at a single institution. Demographic information, time from injury to surgery, mechanism of injury, extent of the tear, pre-existing enthesopathy, perioperative complications, and validated patient-reported outcome scores were included in the analysis. Patients with a minimum of 1-year follow-up were included.

Results:

The most common mechanisms of injury were direct elbow trauma (44.9%), extension/lifting exercises (20.3%), overuse (17.4%), and hyperflexion or hyperextension (17.4%). Eighteen patients were identified with pre-existing symptomatic enthesopathy, and 51 tears were caused by an acute injury. A total of 36 complete and 33 partial tendon tears were identified. Bone tunnels were most commonly used (n = 30; 43.5%), while direct sutures (n = 23; 33.3%) and suture anchors (n = 13; 18.8%) were also used. Perioperative complications occurred in 21.7% of patients, but no patients experienced a rerupture at the time of final follow-up. No statistically significant relationship was found between patient age (P = .750), degree of the tear (P = .613), or surgical technique employed (P = .608) and the presence of perioperative complications.

Conclusion:

Despite the heightened risk of perioperative complications after primary repair of distal triceps tendon injuries, the current series found favorable functional outcomes and no cases of reruptures at short-term to midterm follow-up. Furthermore, age, surgical technique, extent of the tear, and mechanism of injury were not associated with adverse patient outcomes in this investigation. Pre-existing triceps enthesopathy was shown to be associated with increased complication rates.

KEYWORDS:

athletic training; elbow; enthesopathy; general sports trauma

Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: B.R.W. has received research support from Arthrex and Encore Medical; educational support from Arthrex, Desert Mountain Medical, Medwest, and Smith & Nephew; honoraria from Vericel; speaking fees from Genzyme; hospitality payments from DePuy and Wright Medical; and publishing royalties from Elsevier. B.J.C. has received research support from Aesculap/B. Braun, Arthrex, Geistlich, Medipost, Novartis, Sanofi-Aventis, and Zimmer; consulting fees from Anika Therapeutics, Arthrex, Bioventus, Flexion, Genzyme, Regentis, Pacira, Smith & Nephew, Zimmer, and Vericel; speaking fees from Carticept and Pacira; has stock/stock options in Aqua Boom, Biomerix, GiteliScope, Ossio, and Regentis; receives royalties from Arthrex, DJ Orthopedics, Encore Medical, and Saunders/Mosby-Elsevier; and has received hospitality payments from Athletico, DePuy, JRF Ortho, LifeNet Health, and Tornier. A.A.R. has received research support from Aesculap/B. Braun, Arthrex, Histogenics, Medipost, NuTech, OrthoSpace, Smith & Nephew, and Zimmer; consulting fees from Arthrex; royalties from Arthrex, Saunders/Mosby-Elsevier, SLACK, and Wolters Kluwer Health; and is a board or committee member for Atreon Orthopedics. R.W.W. has received speaking fees from Synthes. M.S.C. has received consulting fees from Acumed and Integra LifeSciences, speaking fees from Synthes, and royalties from Acumed and Integra LifeSciences. N.N.V. has received research support from Arthrex, Arthrosurface, DJ Orthopedics, Ossur, and Smith & Nephew; educational support from Medwest; consulting fees from Arthrex, Medacta, Minivasive, OrthoSpace, and Smith & Nephew; speaking fees from Pacira; hospitality payments from Stryker and Wright Medical; royalties from Smith & Nephew and Vindico Medical Education–Orthopedics Hyperguide; and has stock/stock options in CyMedica Orthopedics, Minivasive, and Omeros. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

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