title: Interference screw vs. suture anchor fixation for open subpectoral biceps tenodesis: does it matter?
abstract: BACKGROUND
  Bioabsorbable interference screw fixation has superior biomechanical properties compared to suture anchor fixation for biceps tenodesis. However, it is unknown whether fixation technique influences clinical results.
  
  
  OBJECTIVE
  We hypothesize that subpectoral interference screw fixation offers relevant clinical advantages over suture anchor fixation for biceps tenodesis.
  
  
  METHODS
  Case Series.
  
  
  METHODS
  We performed a retrospective review of a consecutive series of 88 patients receiving open subpectoral biceps tenodesis with either interference screw fixation (34 patients) or suture anchor fixation (54 patients). Average follow up was 13 months. Outcomes included Visual Analogue Pain Scale (0-10), ASES score, modified Constant score, pain at the tenodesis site, failure of fixation, cosmesis, deformity (popeye) and complications.
  
  
  RESULTS
  There were no failures of fixation in this study. All patients showed significant improvement between their preoperative and postoperative status with regard to pain, ASES score, and abbreviated modified Constant scores. When comparing IF screw versus anchor outcomes, there was no statistical significance difference for VAS (p = 0.4), ASES score (p = 0.2), and modified Constant score (P = 0.09). One patient (3%) treated with IF screw complained of persistent bicipital groove tenderness, versus four patients (7%) in the SA group (nonsignificant).
  
  
  CONCLUSIONS
  Subpectoral biceps tenodesis reliably relieves pain and improves function. There was no statistically significant difference in the outcomes studied between the two fixation techniques. Residual pain at the site of tenodesis may be an issue when suture anchors are used in the subpectoral location.
authors.affiliation: Steadman Hawkins Clinic & Steadman Hawkins Research Foundation, 181 West Meadow Drive, Suite 1000, Vail, CO, USA. drmillett@steadman-hawkins.com
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Millett
authors.forename: Brett
authors.initials: B
authors.lastname: Sanders
authors.forename: Reuben
authors.initials: R
authors.lastname: Gobezie
authors.forename: Sepp
authors.initials: S
authors.lastname: Braun
authors.forename: Jon J P
authors.initials: JJ
authors.lastname: Warner
mesh_terms: D000328:Adult; D000368:Aged; D001132:Arm / Q000503:physiopathology / Q000601:surgery*; D001696:Biomechanical Phenomena; D001863:Bone Screws / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D012782:Shoulder / Q000503:physiopathology / Q000601:surgery*; D020069:Shoulder Pain / Q000209:etiology / Q000601:surgery; D053441:Suture Anchors / Q000009:adverse effects; D053656:Tenodesis / Q000379:methods*; D016896:Treatment Outcome
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