Use of a Bio-Inductive Collagen Implant in Distal Triceps Tendon Repair: A Case Report

Distal triceps tendon injuries are uncommon but clinically significant, typically occurring after heavy eccentric loading and resulting in loss of active elbow extension. Complete ruptures are traditionally treated with surgical repair using transosseous tunnels or suture anchors; however, high retear rates have been reported following traditional repair techniques. Bio-inductive collagen implants have demonstrated efficacy in augmenting rotator cuff repair by promoting neovascularization and tissue regeneration; however, their use in distal triceps tendon injuries has not been previously reported. A 59-year-old male agricultural worker with a history of tobacco use presented with an acute complete distal triceps tendon rupture sustained while climbing into farm equipment. Physical examination revealed an inability to actively extend the elbow against resistance and a palpable defect over the distal triceps tendon. Magnetic resonance imaging confirmed a full-thickness tear with 1.5 cm of proximal tendon retraction from the olecranon insertion. The patient underwent open surgical repair using two suture anchors with a whipstitch technique augmented with a resorbable bio-inductive collagen implant secured over the repair site. At two weeks postoperatively, the surgical incision was well-healed without complications. By six weeks, the patient achieved active elbow motion from 10° to 90° of flexion. After three months, a full range of motion and near-normal triceps strength were restored. At one-year follow-up, magnetic resonance imaging demonstrated complete implant resorption, intact tendon continuity, and no evidence of retear. No adverse immunological reactions or postoperative complications were observed. This case demonstrates the technical feasibility and safety of bio-inductive collagen implant augmentation in distal triceps tendon repair, with excellent functional recovery at one-year follow-up. These findings provide a proof-of-concept for the use of bio-inductive augmentation in distal triceps repair and support further investigation in larger comparative studies.