Author Topic: Distal biceps rupture repair procedures  (Read 4804 times)

Offline Brian J

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Distal biceps rupture repair procedures
« on: September 01, 2008, 02:54:33 AM »
Six originally posted a link to the following website: http://www.rcsed.ac.uk/fellows/lvanrensburg/classification/approaches/default.htm.  Scroll down to Elbow > Other > Distal Biceps Tendon.  Surgeries are grouped into two categories: one-incision and two-incision.  With the one-incision technique, re-attachment of the tendon is achieved using either the EndoButton or suture anchors.  With a two-incision surgery, re-attachment is performed using either transosseous sutures or suture anchors.  Also see http://mygeologypage.ucdavis.edu/joy/distal%20biceps%20tendon%20references/.
« Last Edit: July 06, 2009, 12:27:27 AM by Brian J »
  • Hospital: Specialized Orthopedic Surgeons, Davis, California
  • Repair Method: two incisions/transosseous sutures
  • Surgeon: Drs. Metheny and Smith-Hoefer
  • Surgery Date: 28 May 2008
Brian Joy
Kingston, Ontario

Offline Brian J

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Re: Distal biceps rupture repair procedures
« Reply #1 on: September 04, 2008, 09:06:41 PM »
I add new files to that folder periodically, though not on a regular basis.  I keep meaning to post a bibliography -- I'll do that sometime in the next few days.
  • Hospital: Specialized Orthopedic Surgeons, Davis, California
  • Repair Method: two incisions/transosseous sutures
  • Surgeon: Drs. Metheny and Smith-Hoefer
  • Surgery Date: 28 May 2008
Brian Joy
Kingston, Ontario

Offline Brian J

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Re: Distal biceps rupture repair procedures
« Reply #2 on: September 05, 2008, 08:13:03 AM »
I've put a bibliography of references on distal biceps tendon rupture and repair here: http://mygeologypage.ucdavis.edu/joy/distal%20biceps%20tendon%20references/bibliography/.  I've saved it in rtf format, which should open in most word processors or WordPad.  I've also included the EndNote (.enl) file in case you have this software.  I'll update these files as I come across new references.
« Last Edit: July 06, 2009, 12:24:44 AM by Brian J »
  • Hospital: Specialized Orthopedic Surgeons, Davis, California
  • Repair Method: two incisions/transosseous sutures
  • Surgeon: Drs. Metheny and Smith-Hoefer
  • Surgery Date: 28 May 2008
Brian Joy
Kingston, Ontario

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Re: Distal biceps rupture repair procedures
« Reply #3 on: September 07, 2008, 05:14:41 PM »
Six originally posted a link to the following website: http://www.rcsed.ac.uk/fellows/lvanrensburg/classification/approaches/default.htm.  Scroll down to Elbow > Other > Distal Biceps Tendon.  Surgeries are grouped into two categories: one-incision and two-incision.  With the one-incision technique, re-attachment of the tendon is achieved using either the EndoButton or suture anchors.  With a two-incision surgery, re-attachment is performed using either transosseous sutures or suture anchors.  Also see http://home.geology.ucdavis.edu/~joy/.

Offline kweidman

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Re: Distal biceps rupture repair procedures
« Reply #4 on: September 17, 2008, 01:03:26 PM »
I read through that one link that has all the details after the surgery, and I gotta say there are some SERIOUS BS claims. One guy said he was curling "light weight" at 2 weeks. One guy said he was riding his motorcycle at 5 weeks and another guy said he was golfing at 6 weeks. I dont understand if they are lying, for whatever reason, or just complete MORONS. Am I the only person that thinks this?

Offline Brian J

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Re: Distal biceps rupture repair procedures
« Reply #5 on: September 17, 2008, 01:10:40 PM »
Kevin -- I only report what people state in their posts.  I guess I assume that what they write is true.
  • Hospital: Specialized Orthopedic Surgeons, Davis, California
  • Repair Method: two incisions/transosseous sutures
  • Surgeon: Drs. Metheny and Smith-Hoefer
  • Surgery Date: 28 May 2008
Brian Joy
Kingston, Ontario

Offline Brian J

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Re: Distal biceps rupture repair procedures
« Reply #6 on: September 17, 2008, 02:41:37 PM »
Also, I agree that people are doing some pretty crazy stuff way too early.  That's why my doctor put me in a cast for nearly five weeks. :-\
  • Hospital: Specialized Orthopedic Surgeons, Davis, California
  • Repair Method: two incisions/transosseous sutures
  • Surgeon: Drs. Metheny and Smith-Hoefer
  • Surgery Date: 28 May 2008
Brian Joy
Kingston, Ontario

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Re: Distal biceps rupture repair procedures
« Reply #7 on: September 27, 2008, 11:37:51 AM »
I am curious and I am sure some of you understand how the medical field test certain procedures but I do not. On some reports it talks about the strenth of the 2 incision tie to the single endobutton. How do they test that and on who. Cadavors or living? If cadavors, are they doing the procedure and then trying to pop it with force becouse there would be no healing process. And if live humans do the test how do they test them. Again I do not know the medical fields testing procedures do any of you? ( I know maybe they use rats!!!!!) 

Offline Brian J

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Re: Distal biceps rupture repair procedures
« Reply #8 on: September 27, 2008, 10:28:51 PM »
Gary -- Those “biomechanical” strength tests are done on thawed out frozen old dead guys.   A surgeon cuts the distal biceps tendon, then repairs it as would be done on a living person, and then the tendon is loaded to failure (pulled parallel to its length -- see illustrations of apparatus in Idler et al. or Mazzocca et al., for instance).  I have no idea if a thawed out frozen old dead guy serves as a good representation of a 40-year old healthy living guy.  Probably not.  The following references (http://mygeologypage.ucdavis.edu/joy/distal%20biceps%20tendon%20references/) describe studies of this type:

Berlet et al. (1998)
Greenberg et al. (2003)
Henry et al. (2007)
Idler et al. (2006)
Kettler et al. (2007, 2008)
Krushinski et al. (2007)
Lemos et al. (2004)
Mazzocca et al. (2007)
Pereira et al. (2002)
Spang et al. (2006)
« Last Edit: July 06, 2009, 12:22:46 AM by Brian J »
  • Hospital: Specialized Orthopedic Surgeons, Davis, California
  • Repair Method: two incisions/transosseous sutures
  • Surgeon: Drs. Metheny and Smith-Hoefer
  • Surgery Date: 28 May 2008
Brian Joy
Kingston, Ontario

Offline shawn

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Re: Distal biceps rupture repair procedures
« Reply #9 on: October 10, 2008, 05:53:57 PM »
Great job at finding all this information it relly has been a big help.

Offline mbb

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Re: Distal biceps rupture repair procedures
« Reply #10 on: October 11, 2008, 02:03:03 PM »
ive seen various tests that show the strenghth of repair on cadavers varied greatly, like about 2x.  in any case, no tests are out there comparing failure loads on healthy healed arms. After healing, they are all the same, the real concern is minimizing cost, recovery time, and complications from surgery.

for those that cant convert, 250 newtons is about 55 lb force.  given the leverage implied by the distance of hand-elbow relative to repair-elbow distance, it would only take maybe 5-7 lbs in the hand to pull out type repair, neglecting that other muscles beside bicep are carrying part of load.  when you curl 50 lb, that bicep contracts with several hundred lb force.

Offline Brian J

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Re: Distal biceps rupture repair procedures
« Reply #11 on: November 06, 2008, 01:56:02 PM »
Check out this paper I just found:

http://mygeologypage.ucdavis.edu/joy/distal%20biceps%20tendon%20references/Cil%20et%20al%202008.pdf

I wonder what my surgeon would think.  He used essentially the same surgical technique (2-incision transosseous suture), but put me in a full cast for 34 days.
« Last Edit: July 06, 2009, 12:19:59 AM by Brian J »
  • Hospital: Specialized Orthopedic Surgeons, Davis, California
  • Repair Method: two incisions/transosseous sutures
  • Surgeon: Drs. Metheny and Smith-Hoefer
  • Surgery Date: 28 May 2008
Brian Joy
Kingston, Ontario

Offline madkins

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Re: Distal biceps rupture repair procedures
« Reply #12 on: October 16, 2009, 04:47:40 PM »
OK here is my disclaimer: I am light years from being a medical professional and I virtually pass out when the Dr starts talking in detail about my surgery...

I had a procedure done called "interference screw fixation" which I guess is very common with ACL repairs and is now being used for distal bicep. I have one "S" shaped incision on the inside of my elbow may 2-2.5" long overall. The procedure involves drilling a hole in the bone, possibly some type of moly-bolt and a screw??? (This is the part where I tried to lie down and get some blood to my brain). The net result is I am 4 weeks PO and feel pretty good. The Dr, as of today, opened my ROM brace up to 15 degrees extension and 135 degrees flexion. He has cleared me to go without the brace at home while idle  and I am starting PT/OT next week. Although I think the PT/OT will be kind of a joke (I work part time at a gym as Group Fitness Yoga based class instructor (Les Mills Body Flow) and was working out on a very regular and consistent basis)...

Long story short this procedure seems to work well as the Dr says I am "ahead of schedule" going on to sing the praises of this technique and I am a lot less bummed out about my situation. Might be something for those considering surgery to look into...

Mike

Offline Bob77

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Re: Distal biceps rupture repair procedures
« Reply #13 on: October 19, 2009, 09:29:00 AM »
Mike. If you get a good PT it won't be a joke, and I found PT to be well worth it. I've worked out all my life (well since 14 years old), and know enough about lifting, but the PT was very good. She had enough different things (that I would not have thought of) to keep it interesting, especially when I couldn't lift anything, or was lifting very light weight.
  • Hospital: Miriam Hospital
  • Repair Method: Endo; Single incision
  • Surgeon: Dr Shalvoy
  • Surgery Date: 8/30/13 and 5/4/08