title: MR imaging findings in flexed abducted supinated (FABS) position and clinical presentation following refixation of distal biceps tendon rupture using bioabsorbable suture anchors.
abstract: OBJECTIVE
  To correlate MRI findings after suture anchor repair of distal biceps tendons with symptoms.
  
  
  METHODS
  24 men with 25 distal biceps tendon ruptures (one bilateral) treated with suture anchor repair were retrospectively included. Follow-up after a mean of 31 months (range, 12-74) included clinical examination and MRI. The pain level and flexion strength compared to the uninvolved arm were recorded. MRI was performed at 1.5 T obtaining FABS position images (both elbows in 7 patients) and evaluated for artifacts, signal abnormalities, and rerupture by two experienced readers in consensus and blinded to symptoms. Pain and loss of flexion strength>20% were tested against MRI findings as dichotomous data using Fisher's exact chi-square tests (p<0.05). Crosssectional areas of operated and uninvolved tendons were measured and evaluated with the Wilcoxon signed rank test (p<0.05).
  
  
  RESULTS
  FABS views enabled good evaluation in 96% of tendons. Rerupture was present in 3 of 25 elbows. Tendinous signal increase was seen in 59% of intact tendons. We found activity-related pain or pain at rest in 32% and a loss of flexion strength in 27 % of these cases. Testing revealed no significant correlation for any of the MRI features with any of the clinical parameters (p>0.05). There was a 2.7-fold mean increase of the tendon cross-sectional area on the repaired side compared to the uninvolved contralateral tendon (p=0.02).
  
  
  CONCLUSIONS
  We found good MRI visualization of postoperative tendons, but no correlation between symptoms and MRI signal abnormalities or rerupture. The increase in caliber of the repaired tendon might promote an impingement in pronation.
authors.affiliation: Klinik für Radiologie, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany. tim.marnitz@charite.de
authors.forename: T
authors.initials: T
authors.lastname: Marnitz
authors.forename: D
authors.initials: D
authors.lastname: Spiegel
authors.forename: K
authors.initials: K
authors.lastname: Hug
authors.forename: M
authors.initials: M
authors.lastname: Hüper
authors.forename: C
authors.initials: C
authors.lastname: Gerhardt
authors.forename: I G
authors.initials: IG
authors.lastname: Steffen
authors.forename: T
authors.initials: T
authors.lastname: Denecke
authors.forename: S
authors.initials: S
authors.lastname: Greiner
authors.forename: M
authors.initials: M
authors.lastname: Scheibel
authors.forename: F A
authors.initials: FA
authors.lastname: Elgeti
mesh_terms: D000328:Adult; D004550:Elbow / Q000473:pathology* / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D013484:Supination; D053441:Suture Anchors; D013708:Tendon Injuries / Q000175:diagnosis* / Q000601:surgery*