Outpatient versus At-Home Physical Therapy Following Distal Biceps Repair

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.

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.

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.

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.