title: Biomechanical evaluation of open suture anchor fixation versus interference screw for biceps tenodesis.
abstract: Biceps tenodesis provides reliable pain relief for patients with biceps tendon abnormality. Previous cadaver studies have shown that, for biceps tenodesis, an interference screw provides biomechanical strength to failure superior to that of suture anchors. This finding has led some providers to conclude that screw fixation for biceps tenodesis is superior to suture anchor fixation. The purpose of the current study was to test the hypothesis that the strength of a 2-suture-anchor technique with closing of the transverse ligament is equal to that of interference screw fixation for biceps tenodesis.In 6 paired, fresh-frozen cadaveric shoulder specimens, we excised the soft tissue except for the biceps tendon and the transverse ligament. We used 2 different methods for biceps tenodesis: (1) suture anchor repair with closing of the transverse ligament over the repair, and (2) interference screw fixation of the biceps tendon in the bicipital groove. Each specimen was preloaded with 5 N and then stretched to failure at 5 mm/sec on a materials testing machine. The load-to-failure forces of each method of fixation were recorded and compared. Mean loads to failure for the suture anchor and interference screw repairs were 263.2 N (95% confidence interval [CI], 221.7-304.6) and 159.4 N (95% CI, 118.4-200.5), respectively. Biceps tenodesis using suture anchors and closure of the transverse ligament provided superior load to failure than did interference screw fixation. This study shows that mini-open techniques using 2 anchors is a biomechanically comparable method to interference fixation for biceps tendon tenodesis.
authors: Division of Shoulder Surgery and the International Center for Orthopedic Advancement, the Department of Orthopedic Surgery, The Johns Hopkins University/Johns Hopkins Bayview Medical Center, Baltimore, Maryland, USA.
authors: Derek F
authors: DF
authors: Papp
authors: Nathan W
authors: NW
authors: Skelley
authors: Edward G
authors: EG
authors: Sutter
authors: Jong Hun
authors: JH
authors: Ji
authors: Carl H
authors: CH
authors: Wierks
authors: Stephen M
authors: SM
authors: Belkoff
authors: Edward G
authors: EG
authors: McFarland
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D001863:Bone Screws; D002102:Cadaver; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology / Q000601:surgery*; D012782:Shoulder / Q000503:physiopathology / Q000601:surgery; D053441:Suture Anchors; D013708:Tendon Injuries / Q000150:complications / Q000601:surgery; D053656:Tenodesis / Q000295:instrumentation* / Q000379:methods