Synthetic Augmented Suture Anchor Reconstruction for a Complete Traumatic Distal Triceps Tendon Rupture in a Male Professional Bodybuilder with Postoperative Biomechanical Assessment

Abstract

Bodybuilding is a high-risk sport for distal triceps tendon ruptures. Management, especially in high-demanding athletes, is operative with suture anchor refixation technique being frequently used. However, the rate of rerupture is high due to underlying poor tendon quality. Thus, additional augmentation could be useful. This case report presents a reconstruction technique for a complete traumatic distal triceps tendon rupture in a bodybuilder with postoperative biomechanical assessment. A 28-year-old male professional bodybuilder was treated with a synthetic augmented suture anchor reconstruction for a complete triceps tendon rupture of his right dominant elbow. Postoperative biomechanical assessment included isokinetic elbow strength and endurance testing by using multiple angular velocities to simulate the “off-season” and “precompetition” phases of training. Eighteen months postoperatively and after full return to training, the biomechanical assessment indicated that the strength and endurance of the operated elbow joint was fully restored with even higher ratings compared to the contralateral healthy arm. The described reconstruction technique can be considered as an advisable option in high-performance athletes with underlying poor tendon quality due to high tensile strength and lack of donor site morbidity, thus enabling them to restore preinjury status and achieve safe return to sports.

Traumatic Rupture of the Distal Triceps Tendon (A Series of 7 Cases)

“…According to these experiences, refixation of the triceps tendon needs to withstand high pull out forces and can be difficult. Nikolaidou et al report in their case study extension forces up to 40Nm in bodybuilders [ 33 ].…”

Ruptura parcial do tríceps distal em um atleta: Relato de caso e descrição de técnica cirúrgica

“…Khiami et al 9 described a case of partial rupture in which the medial triceps head was reinserted into the olecranon and sutured to the remaining muscle. Nikolaidou et al 10 performed an 18-month postoperative isokinetic evaluation in a bodybuilder patient submitted to the reconstruction of a total triceps rupture using a synthetic graft. The patient presented superior outcomes on the operated side in all evaluated parameters.…”

“…Khiami et al 9 descreveram um caso de ruptura parcial em que fizeram a reinserção da cabeça medial do tríceps no olécrano e essa parte ainda foi suturada ao restante do músculo. No estudo de Nikolaidou et al, 10 foi feita a avaliação isocinética com 18 meses de pós-operatório em um paciente fisiculturista submetido a reconstrução de uma ruptura total do tríceps com enxerto sintético. O paciente apresentou resultados superiores no lado operado em todos os parâmetros avaliados.…”