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 athome physical therapy compared to outpatient physical therapy following distal biceps tendon r epair.Methods: A retrospective review of distal biceps repairs performed between ۲۰۱۲ and ۲۰۱۷ by four fellowshiptrained 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 ۶.۳ years for patients who attended outpatient physical therapy and ۵.۹ 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 ۶ 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. Level of evidence: IV

Keywords:

at-home therapy , Distal biceps repair , distal biceps rupture , outpatient therapy , physical therapy