Pathology involving the long head of the biceps tendon is a common source of shoulder pain. Biceps tenodesis has been successfully used in areas below the pectoralis, above the pectoralis, and above the biceps groove. However, clinical data are lacking for additional techniques for tenodesis at the superior aspect of the biceps groove.
Methods
A biomechanical comparison was completed examining six matched pairs of cadaveric shoulders. The ultimate load to failure was compared between an inlay and onlay biceps tenodesis at the superior aspect of the biceps groove.
Results
The results demonstrate an average construct strength of 215 N for the inlay technique and 210 N for the onlay technique. The difference between the two techniques was not significant.
Conclusions
This study demonstrates similar biomechanical strength for both constructs.
FriedmanJLFitzPatrickJLRylanderLS, et al.Biceps tenotomy versus tenodesis in active patients younger than 55 years is there a difference in strength and outcomes?Orthop J Sports Med2015; 3: 6–6.
2.
SlenkerNRLawsonKCiccottiMG, et al.Biceps tenotomy versus tenodesis: clinical outcomes. Arthroscopy2012; 28: 576–582.
3.
GaldiBSouthrenDLBrabstonEW, et al.Patients have strong preferences and perceptions for biceps tenotomy versus tenodesis. Arthroscopy2016; 32: 2444–2450.
4.
WernerBCBrockmeierSFGwathmeyFW. Trends in long head biceps tenodesis. Am J Sports Med2015; 43: 570–578.
5.
WernerBCLyonsMLEvansCL, et al.Arthroscopic suprapectoral and open subpectoral biceps tenodesis: a comparison of restoration of length-tension and mechanical strength between techniques. Arthroscopy2015; 31: 620–627.
6.
LuttonDMGrusonKIHarrisonAK, et al.Where to tenodese the biceps: proximal or distal?Clin Orthop Rel Res2011; 469: 1050–1055.
7.
AbrahamVTTanBHMKumarVP. Systematic review of biceps tenodesis: arthroscopic versus open. Arthroscopy2016; 32: 365–371.
8.
GomberaMMKahlenbergCANairR, et al.All-arthroscopic suprapectoral versus open subpectoral tenodesis of the long head of the biceps brachii. Am J Sports Med2015; 43: 1077–1083.
9.
De VilliersDJLohBTaceyM, et al.Proximal versus distal screw placement for biceps tenodesis: a biomechanical study. J Orthop Surg2016; 24: 258–261.
10.
NhoSJReiffSNVermaNN, et al.Complications associated with subpectoral biceps tenodesis: low rates of incidence following surgery. J Shoulder Elbow Surg2010; 19: 764–768.
11.
RichardsDPBurkhartSS. A biomechanical analysis of two biceps tenodesis fixation techniques. Arthroscopy2005; 21: 861–866.
12.
MazzoccaADBicosJSantangeloS, et al.The biomechanical evaluation of four fixation techniques for proximal biceps tenodesis. Arthroscopy2005; 21: 1296–1306.
13.
GolishSRCaldwellPEMillerMD, et al.Interference screw versus suture anchor fixation for subpectoral tenodesis of the proximal biceps tendon: a cadaveric study. Arthroscopy2008; 24: 1103–1108.
14.
PatzerTSantoGOlenderGD, et al.Suprapectoral or subpectoral position for biceps tenodesis: biomechanical comparison of four different techniques in both positions. J Shoulder Elbow Surg2012; 21: 116–125.
15.
TashjianRZHenningerHB. Biomechanical evaluation of subpectoral biceps tenodesis: dual suture anchor versus interference screw fixation. J Shoulder Elbow Surg2013; 22: 1408–1412.
16.
SethiPMRajaramABeitzelK, et al.Biomechanical performance of subpectoral biceps tenodesis: a comparison of interference screw fixation, cortical button fixation, and interference screw diameter. J Shoulder Elbow Surg2013; 22: 451–457.
17.
AroraASSinghAKoonceRC. Biomechanical evaluation of a unicortical button versus interference screw for subpectoral biceps tenodesis. Arthroscopy2013; 29: 638–644.
18.
HongCKHsuKLKuanFC, et al.Biomechanical evaluation of a transtendinous all-suture anchor technique versus interference screw technique for suprapectoral biceps tenodesis in a cadaveric model. Arthroscopy2018; 34: 1755–1761.
19.
BaleaniMFrancesconiDZaniL, et al.Suprapectoral biceps tenodesis: a biomechanical comparison of a new “soft anchor” tenodesis technique versus interference screw biceps tendon fixation. Clin Biomech2015; 30: 188–194.
20.
GreenJMGetelmanMHSnyderSJ, et al.All-arthroscopic suprapectoral versus open subpectoral tenodesis of the long head of the biceps brachii without the use of interference screws. Arthroscopy2017; 33: 19–25.
21.
JayamoorthyTFieldJRCostiJJ, et al.Biceps tenodesis: a biomechanical study of fixation methods. J Shoulder Elbow Surg2004; 13: 160–164.
22.
VestermarkGHartiganDPiaseckiD, et al.Biceps tenodesis: biomechanical assessment of 3 arthroscopic suprapectoral techniques. Orthopedics2017; 40: E1009–E1016.
23.
BradyPCNarbonaPAdamsCR, et al.Arthroscopic proximal biceps tenodesis at the articular margin: evaluation of outcomes, complications, and revision rate. Arthroscopy2015; 31: 470–476.
