Spontaneous Distal Biceps Tendon Ruptures: Are They Related to Statin Administration?

Savvidou, Christiana; Moreno, Rodrigo

doi:10.1142/s0218810412500153

Cited by 28 publications

(28 citation statements)

References 18 publications

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“…Epidemiological studies identified some potential chemical risk factors for distal biceps tendon ruptures, including abuse of nicotine, steroids and statins [1, 3]. Hypertrophic changes at the radial tuberosity have been traditionally been related to distal biceps tendon degeneration and rupture [6].…”

Section: Discussionmentioning

confidence: 99%

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The Size of the Radial Tuberosity is Not Related to the Occurrence of Distal Biceps Tendon Ruptures: A Case-Control Study

Kodde

Bekerom

Mulder³

et al. 2016

TOORTHJ

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Introduction: Hypertrophic changes at the radial tuberosity have traditionally been related to distal biceps tendon degeneration and rupture. From supination to pronation of the forearm, the space available for the distal biceps tendon between de lateral ulna and radial bicipital tuberosity (RBT) decreases by almost 50%. A hypertrophic change at the radial tuberosity further reduces this space with impingement of the distal biceps tendon as a result. The purpose of this study was to evaluate whether the size of the RBT plays a role in the pathophysiology of distal biceps tendon ruptures. Materials and Methods: Twenty-two consecutive patients with a surgically proven distal biceps tendon rupture were matched to controls, in a 1:1 ratio. The size of the RBT was expressed as a ratio of the maximum diameter of the radius at the RBT to the diameter of the diaphysis just distal to the RBT (RD ratio), measured on standard radiographs of the elbow. The RD ratio of patients and matched controls were compared. Results:The mean RD ratio in control group was 1.25 and not significantly different from the mean 1.30 in the group of patients with a distal biceps tendon rupture. Each 0.1 point increase in RD ratio results in an estimated 60% increase of the rupture odds, which was not significant either.Conclusion:Based on the RD ratio on conventional radiographs of the elbow, there was no significant difference in RBT size between patients with a distal biceps tendon rupture and matched controls without biceps tendon pathology.

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Section: Discussionmentioning

confidence: 99%

“…Abuse of tobacco and steroids and the use of statins are associated with an increased risk on rupturing the biceps tendon [2, 3]. Ruptures of the distal biceps tendon have also been described in athletes [4, 5].…”

Section: Introductionmentioning

confidence: 99%

The Size of the Radial Tuberosity is Not Related to the Occurrence of Distal Biceps Tendon Ruptures: A Case-Control Study

Kodde

Bekerom

Mulder³

et al. 2016

TOORTHJ

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“…There are case-reports that describe spontaneous tendon ruptures during statin use [3–5]. A few retrospective studies and one case-control study [2, 5–8] also indicate that there might be a connection between statin treatment and tendon complications. However the connection is far from established, nor is there any clear mechanistic explanation for this coupling.…”

Section: Introductionmentioning

confidence: 99%

Simvastatin and atorvastatin reduce the mechanical properties of tendon constructs in vitro and introduce catabolic changes in the gene expression pattern

et al. 2017

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Treatment with lipid-lowering drugs, statins, is common all over the world. Lately, the occurrence of spontaneous tendon ruptures or tendinosis have suggested a negative influence of statins upon tendon tissue. But how statins might influence tendons is not clear. In the present study, we investigated the effect of statin treatment on mechanical strength, cell proliferation, collagen content and gene expression pattern in a tendon-like tissue made from human tenocytes in vitro. Human tendon fibroblasts were grown in a 3D tissue culture model (tendon constructs), and treated with either simvastatin or atorvastatin, low or high dose, respectively, for up to seven days. After seven days of treatment, mechanical testing of the constructs was performed. Collagen content and cell proliferation were also determined. mRNA levels of several target genes were measured after one or seven days. The maximum force and stiffness were reduced by both statins after 7 days (p<0.05), while the cross sectional area was unaffected. Further, the collagen content was reduced by atorvastatin (p = 0.01) and the cell proliferation rate was decreased by both types of statins (p<0.05). Statin treatment also introduced increased mRNA levels of MMP-1, MMP-3, MMP-13, TIMP-1 and decreased levels of collagen type 1 and 3. In conclusion, statin treatment appears to have a negative effect on tendon matrix quality as seen by a reduced strength of the tendon constructs. Further, activated catabolic changes in the gene expression pattern and a reduced collagen content indicated a disturbed balance in matrix production of tendon due to statin administration.

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“…One study was conducted in Taiwan 13 and all others in the US. In two studies, patients were recruited as cases from hospital databases, 14 , 15 with the other studies collecting data from insurance databases 13 , 16 . When people who were not exposed to statins were recruited, they were age‐ and sex‐matched from the same institute as the index case 14 , 16 .…”

Section: Resultsmentioning

confidence: 99%

Statins and tendinopathy: a systematic review

Teichtahl

Brady

Urquhart

et al. 2016

Medical Journal of Australia

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Spontaneous Distal Biceps Tendon Ruptures: Are They Related to Statin Administration?

Cited by 28 publications

References 18 publications

The Size of the Radial Tuberosity is Not Related to the Occurrence of Distal Biceps Tendon Ruptures: A Case-Control Study

The Size of the Radial Tuberosity is Not Related to the Occurrence of Distal Biceps Tendon Ruptures: A Case-Control Study

Simvastatin and atorvastatin reduce the mechanical properties of tendon constructs in vitro and introduce catabolic changes in the gene expression pattern

Statins and tendinopathy: a systematic review

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