Biomechanical Evaluation of Open Suture Anchor Fixation Versus Interference Screw for Biceps Tenodesis

Papp, Derek F.; Skelley, Nathan W.; Sutter, E. Grant; Ji, Jong‐Hun; Wierks, Carl; Belkoff, Stephen M.; McFarland, Edward G.

doi:10.3928/01477447-20110526-04

Cited by 29 publications

(21 citation statements)

References 18 publications

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“…1,10,23 Use of a tenodesis technique may also avoid the biceps muscle-belly cramping that is associated with tenotomy. 1,21 Many authors have described open techniques 8,19,24,27,29 as well as all-arthroscopic techniques for biceps tenodesis. 2,4,13,14,25,32 In a biomechanical assessment of 4 tenodesis techniques (open subpectoral bone tunnel biceps tenodesis, arthroscopic interference screw technique, open subpectoral interference screw fixation technique, and arthroscopic suture anchor tenodesis), there was no statistically significant difference in the ultimate failure strength among any of the techniques tested.…”

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confidence: 99%

All-Arthroscopic Suprapectoral Versus Open Subpectoral Tenodesis of the Long Head of the Biceps Brachii

et al. 2015

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Objectives: Pathology of the long head of the biceps tendon is a recognized source of shoulder pain in adults that can be treated with tenotomy or tenodesis when non-operative measures are not effective. It is not clear whether arthroscopic or open biceps tenodesis has a clinical advantage. To date, we are not aware of any studies that directly compare clinical outcomes between an arthroscopic and an open technique for tenodesis of the long head of the biceps brachii. The purpose of this study was to determine whether a difference in outcomes and complications exists between matched cohorts after biceps tenodesis utilizing an open subpectoral versus an allarthroscopic suprapectoral technique. Methods: A prospective database was reviewed for patients undergoing an all-arthroscopic suprapectoral or open subpectoral biceps tenodesis. Adult patients with a minimum 18-month follow-up were included. Patients undergoing a concomitant rotator cuff or labral repair were excluded. The groups were matched to age within 3 years, sex, and time to follow-up within 3 months. Pain improvement, development of a popeye deformity, muscle cramping, post-operative ASES scores, satisfaction scores, and complications were evaluated. Results: Forty-six patients (23 all-arthroscopic, 23 open) patients with an average age of 57.2 years (range, 45-70) were evaluated at a mean 28.7 months (range, 18-42) follow-up. No patients in either group developed a popeye deformity or complained of arm cramping. There was no significant difference in mean ASES scores between the open and all-arthroscopic groups (92.7 vs. 88.9, P = 0.42, Table 1). Similarly, there was no significant difference between patient satisfaction scores (8.9 vs. 9.1, P = 0.73). Eighteen patients (78.3%) in the arthroscopic cohort and sixteen patients (69.6%) in the open cohort fully returned to athletic activity (P = 0.50). There were no complications in the all-arthroscopic group. There were two complications in the open group (superficial incisional erythema, and brachial plexopathy) that resolved by final follow-up. Conclusion: Biceps tenodesis is a reliable treatment option for pathology of the long head of the biceps that may avoid arm cramping and a cosmetic "popeye" deformity that can occur following tenotomy. Open subpectoral and all-arthroscopic suprapectoral are two commonly used techniques to reattach the biceps tendon distal to the bicipital groove. In this study, patients undergoing an all-arthroscopic tenodesis experienced similar pain relief, shoulder function, and return to athletic activity as patients undergoing an open tenodesis. An open subpectoral technique may increase the risk of complications secondary to a larger incision and increased surgical dissection. Larger studies with longer follow-up would help delineate the long-term effects and potential differences between an allarthroscopic suprapectoral and open subpectoral biceps tenodesis.

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All-Arthroscopic Suprapectoral Versus Open Subpectoral Tenodesis of the Long Head of the Biceps Brachii

et al. 2015

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“…Papp et al, 46 in a biomechanical study in cadavers, assessed the maximum tensile strength of two methods of open LHB tenodesis fixation: interference screw and two metal anchors associated with the repair of the transverse ligament. In both techniques, the LHB fixation was performed in the groove.…”

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confidence: 99%

“…It is also suggested that LHB procedures should not be routinely indicated for the treatment of rotator cuff injuries. The main techniques described for the surgical treatment of LHB disorders were: acromioplasty, debridement, reconstruction of the biceps reflection pulley, tenotomy, and tenodesis 4, 5, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54…”

Section: Discussionmentioning

confidence: 99%

“…The sites described for LHB fixation in the humerus include the proximal portion of the bicipital groove, suprapectoral, subpectoral, or in the soft tissue, such as in the conjoined tendon and the tendon of the pectoralis major muscle. Some authors have suggested that suprapectoral tenodesis as well as tenodesis performed distal to the intertubercular groove have better results regarding residual pain 4, 27, 28, 29, 30, 33, 36, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 52, 53…”

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confidence: 99%

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Disorders of the long head of the biceps: tenotomy versus tenodesis

Ribeiro

Ursolino

Ramos

et al. 2017

Revista Brasileira de Ortopedia (English Edition)

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Disorders of the long head of biceps tendon are common in clinical practice. Their causes could be degenerative, inflammatory, instability (subluxation or luxation) or traumatic. They are generally associated to other diseases of the shoulder, mainly rotator cuff injuries. Currently, there is controversy in the literature regarding the indications for surgical treatment and the choice of the best technique for each case, due to the possibility of esthetic deformity, loss of muscle strength, and residual pain.The objective of this study was to identify the indications for surgical treatment, the best surgical technique, and the advantages and disadvantages of each technique described in the orthopedic literature for the treatment of long head of biceps tendon injuries.A revision of the orthopedic medical literature on the following databases: Biblioteca Regional de Medicina (BIREME), Medline, PubMed, Cochrane Library and Google Scholar, comprising articles published in the period from 1991 to 2015.

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“…Further, it is likely that the postoperative patient in a sling generates cyclic loading conditions far lower than those tested by various investigators. [6][7][8][9][10][11][12][13] Frank et al 1 reported greater elongation for the suture anchor constructs than interference screw fixation. The advantage of construct stiffness is tempered by 2 negatives: early tendon tearing during cyclic testing and the creation of a torsional stress riser.…”

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confidence: 99%

Editorial Commentary: Size Matters: Biomechanical Analysis of All-Suture Suture-Anchor Fixation Compared to Conventional Suture Anchors and Interference Screws for Biceps Tenodesis

Taylor¹

2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Biomechanical Evaluation of Open Suture Anchor Fixation Versus Interference Screw for Biceps Tenodesis

Cited by 29 publications

References 18 publications

All-Arthroscopic Suprapectoral Versus Open Subpectoral Tenodesis of the Long Head of the Biceps Brachii

All-Arthroscopic Suprapectoral Versus Open Subpectoral Tenodesis of the Long Head of the Biceps Brachii

Disorders of the long head of the biceps: tenotomy versus tenodesis

Editorial Commentary: Size Matters: Biomechanical Analysis of All-Suture Suture-Anchor Fixation Compared to Conventional Suture Anchors and Interference Screws for Biceps Tenodesis

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