Purpose
The purpose of this study was to evaluate the results after endoscopic repair of partial
superficial layer triceps tendon tears.
Methods
Fourteen patients treated surgically between July 2005 and December 2012 were studied
prospectively for 12 months. Indication for surgery was a partial detachment of the
triceps tendon from the olecranon that was proved by magnetic resonance imaging (MRI)
in all cases. Ten of these patients had chronic olecranon bursitis. All patients were
treated with endoscopic surgery including bursectomy and repair of the distal triceps
tendon with double-loaded suture anchors. Clinical examination of the patients as
well as functional and subjective scores (Mayo Elbow Performance Index [MEPI], Disabilities
of the Arm, Shoulder and Hand Score [Quick DASH]) were obtained preoperatively and
postoperatively at 6 and 12 months. An isokinetic strength measurement and MRI were
performed preoperatively and 12 months after surgery.
Results
All 14 patients were completely evaluated. The MEPI and Quick DASH Score improved
significantly after the repair at all postoperative examinations. The MEPI gained
29 points, up to 96 points at last follow-up (P < .05), and the Quick DASH Score went down 15.6 points after 12 months to 4.5 points
(P < .05). Maximum extension power improved 55.8%, up to 94.7% at last follow-up compared
with the contralateral side. Using MRI, we found one reruptured partial tear of the
triceps tendon that did not require revision surgery.
Discussion
Although triceps tendon ruptures are generally uncommon, partial superficial tears
might be more common than previously described. Once the diagnosis is made, endoscopic
repair is a method leading to good clinical results with improved function of the
affected elbow.
Conclusions
Endoscopic repair of superficial tears of the triceps tendon is able to restore function
and strength and leads to excellent clinical results after 1 year. Strength recovers
to nearly that of the contralateral side, and serious complications appear to be infrequent.
Level of Evidence
Level IV, therapeutic case series.
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Article info
Publication history
Published online: May 01, 2014
Accepted:
March 6,
2014
Received:
August 5,
2013
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article.
Identification
Copyright
© 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Health Care Cost Consciousness: Testing Triceps Strength Instead of Routinely Ordering Imaging ProceduresArthroscopyVol. 31Issue 2
- PreviewIn an era of cost consciousness, diagnostic tests might best be ordered only when there is a clear indication. Instead of “always” ordering ultrasound or MRI of the triceps tendon in patients with olecranon bursitis as Heikenfeld et al.1 suggest in their recent article, these tests could be limited to those patients with pain and/or weakness on resisted extension of the elbow. As olecranon bursitis is common and accompanying triceps tears are rare, brief physical examination with triceps strength testing simplifies the care and decreases the cost of care for most patients with olecranon bursitis.
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