MRI findings of chronic distal tendon biceps reconstruction and associated post-operative findings
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REVIEW ARTICLE
MRI findings of chronic distal tendon biceps reconstruction and associated post-operative findings Dylan N. Greif 1,2 & Samuel H. Huntley 1,2 & Sameer Alidina 3 & Julianne Muñoz 1,2 & Joseph H. Huntley 4 & Harry G. Greditzer IV 5 & Jean Jose 1,2,6 Received: 21 September 2020 / Revised: 29 October 2020 / Accepted: 15 November 2020 # ISS 2020
Abstract Rupture of the distal biceps tendon is becoming increasingly diagnosed due to an active aging population and an increase in diagnostic imaging opportunities. While physical exam may help in diagnosis, magnetic resonance imaging (MRI) is particularly useful in evaluating chronic rupture. Although partial tears can be managed conservatively, the gold standard treatment for a chronic distal biceps tear is anatomic reinsertion with additional use of an allograft or autograft. No study has highlighted the normal appearance and postsurgical complications seen on MRI associated with allograft or autograft usage. Clinicians and radiologists may be unaware of the normal and abnormal post-operative imaging findings and their clinical relevance. The purpose of this manuscript is to discuss the epidemiology, clinical presentation, and preoperative MRI findings of distal biceps ruptures necessitating reconstruction, to explain distal biceps tendon surgical reconstruction technique with allograft or autograft usage, to display the normal and abnormal post-operative MRI findings, and to review the clinical outcomes associated with the procedure. Keywords Distal biceps tendon . Tear . Autograft . Allograft . Reconstruction . Chronic distal biceps tendon . MRI study of chronic distal biceps tear
Introduction Rupture of the distal biceps tendon (DBT) is becoming increasingly diagnosed due to an active aging population and an increase in diagnostic imaging opportunities [1]. The biceps consists of two parts, the short head arising from the corocoid process and the long head arising from the superior * Jean Jose [email protected] 1
University of Miami Sports Medicine Institute, University of Miami Miller School of Medicine, Coral Gables, FL, USA
2
Department of Orthopaedic Surgery, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA
3
University of Vermont Larner College of Medicine, Burlington, VT, USA
4
East Virginia Medical School, Norfolk, VA, USA
5
Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, USA
6
Department of Radiology, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA
aspect of the glenoid [2]. Tears often result in loss of strength at the elbow due to muscle atrophy [3]. DBT tears can be caused by rapid elbow flexion against resistance and often occur in athletes or manual laborers that lift heavy objects [4]. While physical exam may help in diagnosis, magnetic resonance imaging (MRI) is particularly helpful in evaluating chronic ruptures [5]. Although partial tears can be managed conservatively or operatively with primary anatomic repair
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