Radioulnar Heterotopic Ossification After Distal Biceps Tendon Repair: Results Following Surgical Resection

PurposeThe purpose of this study is to evaluate the clinical outcome of patients who had excision of a radioulnar heterotopic ossification (HO) as a complication of a distal biceps tendon repair. The hypothesis is that there are no measurable clinical losses that persist after excision.MethodsEight consecutive patients were identified between 1996 and 2005. All were treated with HO excision using a standard surgical technique and rehabilitation protocol. These individuals were studied and compared to a matched cohort of 8 patients who had a distal biceps tendon repair with a similar surgical technique that was uncomplicated. All study patients were evaluated at a minimum 1-year follow-up with physical examination, isokinetic dynamometry, and outcome measures. Comparisons were made both between groups as well as side-to-side within groups.ResultsAt follow-up examination, the mean arc of forearm rotation in the HO group measured 151°. The mean arc of forearm rotation in the control group measured 165°. With the numbers available, no measurable differences in arc of motion were identified between groups (p > .05). When compared to the normal, uninvolved side, patients who developed HO lost an average of 9° of forearm pronation (p < .01). No differences were identified between the HO and control groups with respect to isokinetic torque, endurance strength, or Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire (American Academy of Orthopaedic Surgeons, Rosemont, IL) scores (p > .05).ConclusionsWhen patients develop motion-limiting HO after distal biceps tendon repair, surgical resection can lead to a functional recovery of elbow and forearm motion. Biceps strength can be maintained with no measurable differences in clinical outcome when compared to individuals who do not suffer this complication following distal biceps repair.Type of study/level of evidenceTherapeutic III.