A Systematic Review and Meta-analysis of Biceps Tenodesis Fixation Strengths: Fixation Type and Location Are Biomechanically Equivalent

Dekker, Travis J.; Peebles, Liam A.; Preuss, Fletcher R.; Goldenberg, Brandon T.; Dornan, Grant J.; Provencher, Matthew T.

doi:10.1016/j.arthro.2020.05.055

Cited by 18 publications

(19 citation statements)

References 42 publications

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“…16,17 There are some clinical data suggesting improved construct stability with interference screw fixation compared with other fixation techniques, such as suture anchors or buttons. 7 However, other studies have found equivalence in biomechanical performance of all-suture anchors and interference screws, 2,12 with some cadaveric studies suggesting that interference screw may even be inferior with load-to-failure testing. 4 While that may be the case, all cadaveric studies are implicitly time zero and do not allow for tissue remodeling, nor do they necessarily simulate what happens physiologically in vivo, where healing is primarily periosteal.…”

Section: Discussionmentioning

confidence: 99%

No Difference in Clinical Outcomes for Arthroscopic Suprapectoral Versus Open Subpectoral Biceps Tenodesis at Midterm Follow-up: A Randomized Prospective Analysis

et al. 2022

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Background: We have previously reported the 1-year outcomes of arthroscopic suprapectoral biceps tenodesis (ASPBT) versus open subpectoral biceps tenodesis (OSPBT) for the management of long head of the biceps tendon (LHBT) pathology. While patients had similar 1-year biceps muscle strength and pain, longer-term functional outcomes are unknown. Purpose: To directly compare clinical outcomes of ASPBT versus OSPBT with interference screw fixation, distal to the bony bicipital groove, at a minimum of 2 years’ follow-up. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 85 patients undergoing biceps tenodesis (BT) for LHBT disease were randomized into the ASPBT or OSPBT group. Both techniques utilized polyether ether ketone inference screws for tenodesis fixation. Patients completed American Shoulder and Elbow Surgeons (ASES), Constant subjective, and Single Assessment Numeric Evaluation (SANE) questionnaires preoperatively and again at 6 months, 12 months, and at the final follow-up at a minimum of 24 months. Results: A total of 73 patients (37/42 randomized to ASPBT [88%]; 36/42 randomized to OSPBT [86%]) with a mean age of 50.4 ± 10.3 years and a mean body mass index of 29 ± 7.9 were included in clinical outcome analyses. The mean final follow-up was 2.9 years (ASPBT, 3 years; OSPBT, 2.8 years [range 2-5.2 years]). Comparison of demographic characteristics and intraoperative findings showed no significant differences in age, sex, concomitant procedures, and rotator cuff disease. No statistically significant differences in the ASES ( P = .25), Constant subjective ( P = .52), and SANE scores ( P = .61) were found at the final follow-up. Clinical outcomes scores showed no significant improvement from a mean of 12.6 months to the final follow-up at 34.5 months (ASPBT: ASES, P = .43; Constant, P = .25; SANE, P = .45 vs OSPBT: ASES, P = .65; Constant, P = .78; SANE, P = .70). No patients required revision of BT in either group. Conclusion: This study reported a minimum of 2-year follow-up of patients undergoing ASPBT or OSPBT, utilizing the same interference screw technique, for the management of LHBT pathology in the setting of concomitant shoulder procedures. There were no significant differences in patient-reported outcomes and complication rates found at any time point. Registration: NCT02192073 (ClinicalTrials.gov identifier).

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Section: Discussionmentioning

confidence: 99%

No Difference in Clinical Outcomes for Arthroscopic Suprapectoral Versus Open Subpectoral Biceps Tenodesis at Midterm Follow-up: A Randomized Prospective Analysis

et al. 2022

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“…There are many methods for fixing the tendon to the bone: interference screw, suture anchor, and Endobutton have been proposed. Biomechanically, there is no statistical significant difference between the use of screws and suture anchors, as shown by Patzer et al 12 and Dekker et al 13 There is a chance of screw threads damaging the tendon as it goes inside the tunnel. In the postoperative period, the tendon may be damaged by the screw threads as it is compressed against the bone in the tunnel.…”

Section: Discussionmentioning

confidence: 97%

Arthroscopic Biceps Tenodesis by Bicortical Drilling Technique

C้hernchujit

Agrawal

Artha

2021

Arthroscopy Techniques

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Pain arising from the long head of biceps tendon can cause significant disability of the shoulder. In young and physically demanding patients, biceps tenodesis is advised, in which the biceps tendon is cut from the native origin and fixed distally. Many methods have been proposed for this. This Technical Note describes arthroscopic biceps tenodesis in the bicipital groove by a bicortical drilling technique. The far cortex is breached only once by a guide wire, and the reamers do not breach the far cortex. The tendon is fixed in the new position using a PopLok anchor. This technique is safe and easy to perform but presents a learning curve.

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“…Fixation options described include, but are not limited to, sutures, suture anchors, interference screws, and cortical buttons. 16,[27][28][29][30][31] When evaluating clinical outcomes of the 2 fixation methods in the setting of biceps tenodesis, Millett et al 32 found no difference in ASES, visual analog scale, and modified constant scores between all-suture anchors and interference screws over 1-year postoperatively. Frank et al 33 evaluated torsional strength and fracture risk using all-suture anchors, conventional suture anchors, and interference screws.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Single-Portal Suprapectoral Biceps Tenodesis With All-Suture Anchor

Kannan

Cogan

Zhang

2022

Arthroscopy Techniques

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Tenodesis of the long head of the biceps tendon can be performed through arthroscopic and open techniques with various fixation methods and at different locations on the humerus. Many techniques have been described, with controversy surrounding the advantages and disadvantages of each. In this Technical Note, we describe an allarthroscopic, intra-articular, single-portal, suprapectoral biceps tenodesis with an all-suture anchor. This technique also allows for suture passage through the biceps tendon before tenotomy to ensure proper maintenance of the lengthetension relationship of the biceps musculotendinous unit.

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A Systematic Review and Meta-analysis of Biceps Tenodesis Fixation Strengths: Fixation Type and Location Are Biomechanically Equivalent

Cited by 18 publications

References 42 publications

No Difference in Clinical Outcomes for Arthroscopic Suprapectoral Versus Open Subpectoral Biceps Tenodesis at Midterm Follow-up: A Randomized Prospective Analysis

No Difference in Clinical Outcomes for Arthroscopic Suprapectoral Versus Open Subpectoral Biceps Tenodesis at Midterm Follow-up: A Randomized Prospective Analysis

Arthroscopic Biceps Tenodesis by Bicortical Drilling Technique

Arthroscopic Single-Portal Suprapectoral Biceps Tenodesis With All-Suture Anchor

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