title: Transfer of the long head of biceps to the conjoint tendon. A biomechanical study.
abstract: BACKGROUND
  Tenodesis of the long head of biceps has been intensively investigated and various surgical options exist. The aim of this biomechanical study was to compare the maximum strength of two different techniques for biceps tenodesis. Our hypothesis was that the two procedures have the same biomechanical properties.
  
  
  METHODS
  We performed the two different tenodesis techniques using 12 fresh frozen shoulders divided into two groups of six. In the first group, the biceps was transferred to the conjoint tendon. In the second group, an intraossous suprapectoral tenodesis was performed. After a preload of 10 N, cyclical loading with a maximum of 60 N and 100 N with 100 cycles and 0.5 Hz was applied to the tendons for both groups. An axial ultimate loading to failure was conducted subsequently.
  
  
  RESULTS
  No significant differences were found in age, bone mineral density, or weight between the two groups. During the cyclical loading with 60 N, one slippage of the tendon was observed in the suprapectoral group. The mean ultimate load to failure was 294.15N in the transposition group and 186.76 N in the suprapectoral group, but this difference was not significant (P=0.18).
  
  
  CONCLUSIONS
  The biomechanical results demonstrated equal biomechanical properties postoperatively for both transposition of the tendon and the current standard suprapectoral tenodesis procedure. The transposition can be performed as a primary or a salvage procedure in order to potentially reduce the proportion of patients with persistent postoperative bicipital groove pain and is comparable in strength to a standard tenodesis.
authors: Department of Orthopaedic Surgery, Medical School Hannover, Hannover, Germany. Electronic address: Marc-Frederic.Pastor@ddh-gruppe.de.
authors: M F
authors: MF
authors: Pastor
authors: Laboratory of Biomechanics and Biomaterials, Medical School Hannover, Hannover, Germany. Electronic address: Kraemer.Manuel@mh-hannover.de.
authors: M
authors: M
authors: Kraemer
authors: Laboratory of Biomechanics and Biomaterials, Medical School Hannover, Hannover, Germany. Electronic address: Hurschler.Christof@mh-hannover.de.
authors: C
authors: C
authors: Hurschler
authors: Department of Orthopaedic Surgery, Medical School Hannover, Hannover, Germany. Electronic address: Leif.Claassen@ddh-gruppe.de.
authors: L
authors: L
authors: Claassen
authors: Department of Orthopaedic Surgery, Medical School Hannover, Hannover, Germany. Electronic address: Mathias.Wellmann@ddh-gruppe.de.
authors: M
authors: M
authors: Wellmann
authors: Department of Orthopaedic Surgery, Medical School Hannover, Hannover, Germany. Electronic address: Tomas.Smith@ddh-gruppe.de.
authors: T
authors: T
authors: Smith
mesh_terms: D000328:Adult; D000368:Aged; D001132:Arm / Q000601:surgery; D001696:Biomechanical Phenomena; D001863:Bone Screws; D002062:Bursitis / Q000601:surgery*; D002102:Cadaver; D000071938:Fasciotomy; D006801:Humans; D006811:Humerus / Q000601:surgery; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000601:surgery*; D011312:Pressure; D012782:Shoulder / Q000601:surgery*; D013314:Stress, Mechanical; D013710:Tendons / Q000601:surgery*; D053656:Tenodesis / Q000379:methods*
keywords: Biceps lesion; Biceps tenodesis; Biceps transposition; Superior labrum anterior–posterior lesion (SLAP); Suprapectoral