title: Repair of distal biceps brachii tendon assessed with 3-T magnetic resonance imaging and correlation with functional outcome.
abstract: OBJECTIVE
  Objectives were to study the MRI appearance of the repaired distal biceps tendon (DBT), anatomically reinserted, and to search for a correlation between tendon measurements and functional results.
  
  
  METHODS
  Twenty-five patients (mean age, 49 ± 4.9 years old) who benefited from 3-T MRI follow-up of the elbow after surgical reinsertion of the DBT were retrospectively included and compared to a control group (n = 25; mean age, 48 ± 10 years old). MRI was performed during the month of clinical follow-up and on average 22 months after surgery. Delayed complications (secondary avulsion, new rupture), intratendinous osteoma, tendinous signal on T1-weighted (T1w) and fat-suppressed proton density-weighted (FS-PDw) images as well as DBT measurements were recorded. The maximum isometric elbow flexion strength (MEFS) and range of motion of the elbow were assessed.
  
  
  RESULTS
  Repaired DBT demonstrated a heterogeneous but normally fibrillar structure. Its low T1w signal was less pronounced than that of normal tendons, and the FS-PDW image signal was similar to that of T1w images. MRI detected seven osteomas (Se = 53 % vs. plain radiography), one textiloma and one secondary avulsion. Repaired DBT measurements were significantly correlated with MEFS (dominant arm R2: 0.38; nondominant arm R2: 0.54); this correlation involved the insertion surface (Δ = -75.7 mm(2), p = 0.046), transverse diameter (Δ = -2.6 mm, p = 0.018), anteroposterior diameter at the level of the radial head (Δ = -3.9 mm, p = 0.001) and DBT cross-sectional area (Δ = -50.2 mm(2), p = 0.003).
  
  
  CONCLUSIONS
  The quality of functional outcome after anatomical elbow rehabilitation of DBT correlates with the extent of tendinous hypertrophy during the healing process.
authors.affiliation: Department of Musculoskeletal Imaging, University Hospital of Besancon, 3 boulevard Fleming, 25000, Besancon, France, guillaume.alemann@chru-strasbourg.fr.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Alemann
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Dietsch
authors.forename: David
authors.initials: D
authors.lastname: Gallinet
authors.forename: Laurent
authors.initials: L
authors.lastname: Obert
authors.forename: Bruno
authors.initials: B
authors.lastname: Kastler
authors.forename: Sébastien
authors.initials: S
authors.lastname: Aubry
mesh_terms: D000328:Adult; D004551:Elbow Joint / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D015203:Reproducibility of Results; D012421:Rupture / Q000175:diagnosis / Q000601:surgery; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D013708:Tendon Injuries / Q000175:diagnosis* / Q000601:surgery*; D016896:Treatment Outcome