Biomechanical properties of triceps brachii tendon after in vitro simulation of different posterior surgical approaches

Total elbow arthroplasty is usually performed through a triceps-reflecting or -preserving approach. Weakness of extension is common. The purpose of this study was to compare the in vitro mechanical properties of the triceps tendon after simulation of 3 common exposures. After simulation of the approach and repair, cadaveric specimens were mounted on a material testing system and a constant velocity elongation was applied. The contralateral elbow served as the control. All approaches resulted in a marked weakening of the triceps; however, the Bryan-Morrey lateral triceps-reflecting technique provided statistically better strength than V-Y or longitudinal splitting.