title: Biomechanical Comparison of All-Suture Anchor Fixation and Interference Screw Technique for Subpectoral Biceps Tenodesis.
abstract: To compare the biomechanical characteristics of the subpectoral Y-knot all-suture anchor fixation with those of the interference screw technique.
  
  
  
  Sixteen fresh-frozen human cadaveric shoulders with a mean age of 67.6 ± 5.8 years (range, 52 to 74 years) were studied. The specimens were randomly grouped into 2 experimental biceps tenodesis groups (n = 8): Y-knot all-suture anchor or interference screw. The specimens were cyclically tested to failure by applying tensile forces parallel to the longitudinal axis of the humerus. A preload of 5 N was applied for 2 minutes prior to cyclic loading for 500 cycles from 5 to 70 N at 1 Hz; subsequently, a load-to-failure test at 1 mm/s was performed. The ultimate failure load, stiffness, displacement at cyclic and failure loading, and mode of failure were recorded.
  
  
  
  The all-suture anchor technique displayed values of ultimate failure load and stiffness comparable to that of the interference screw technique. The displacement at cyclic and failure loading of the all-suture anchor trials were significantly greater than the interference screw (P = .0002). The all-suture anchor specimens experienced anchor pullout and tendon tear equally during the trials, whereas the interference screw group experienced tendon tear in most of the cases and screw pullout in 2 trials.
  
  
  
  The Y-knot all-suture anchor fixation provides equivalent ultimate failure load and stiffness when compared with the interference screw technique in tenodesis of the proximal biceps tendon from a subpectoral approach. However, the interference screw technique demonstrates significantly less displacement in response to cyclic and failure loading.
  
  
  
  The all-suture anchor fixation is an alternative technique for subpectoral biceps tenodesis even at greater displacement when compared with the interference screw fixation during cyclic and failure loading.
authors.affiliation: University of Texas Health Science Center at San Antonio School of Medicine, San Antonio, Texas, U.S.A.
authors.forename: Florence L
authors.initials: FL
authors.lastname: Chiang
authors.affiliation: Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Chih-Kai
authors.initials: CK
authors.lastname: Hong
authors.affiliation: Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Chih-Hsun
authors.initials: CH
authors.lastname: Chang
authors.affiliation: Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheung Kung University, Tainan, Taiwan; Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.affiliation: Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheung Kung University, Tainan, Taiwan; Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan.
authors.forename: I-Ming
authors.initials: IM
authors.lastname: Jou
authors.affiliation: Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheung Kung University, Tainan, Taiwan; Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan. Electronic address: suwr@mail.ncku.edu.tw.
authors.forename: Wei-Ren
authors.initials: WR
authors.lastname: Su
mesh_terms: D000368:Aged; D001696:Biomechanical Phenomena; D001863:Bone Screws; D002102:Cadaver; D006801:Humans; D008422:Materials Testing; D008875:Middle Aged; D053441:Suture Anchors; D053656:Tenodesis / Q000295:instrumentation* / Q000379:methods*