Outpatient Versus At-Home Physical Therapy Following Distal Biceps Repair

Articles in Press

Document Type : RESEARCH PAPER

Authors

1 Rothman Orthopaedics, Thomas Jefferson University Hospital, Philadelphia, PA, USA

2 Rothman Orthopaedics, Thomas Jefferson University Hospital, Philadelphia PA, USA

3 Rothman Orthopaedic Institute, Department of Shoulder & Elbow Surgery

4 The Rothman Institute at Thomas Jefferson University

5 Rothman Orthopaedic Institute Department of Orthopaedic Surgery Philadelphia, Pennsylvania

10.22038/abjs.2025.81641.3717

Abstract

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 at-home physical therapy compared to outpatient physical therapy following distal biceps tendon repair.



Methods: A retrospective review of distal biceps repairs performed between 2012 and 2017 by four fellowship-trained 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 6.3 years for patients who attended outpatient physical therapy and 5.9 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 6 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 can achieve equivalent clinical outcomes with a regimented at-home physical therapy protocol in lieu of formal outpatient physical therapy.

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The Archives of Bone and Joint Surgery

Articles in Press, Accepted Manuscript
Available Online from 07 April 2025

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History

  • Receive Date: 04 August 2024
  • Revise Date: 19 February 2025
  • Accept Date: 08 March 2025

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