Journal of ISAKOS : joint disorders & orthopaedic sports medicine · 2025
Biomechanical evaluation of four biceps tenodesis locations: A comparative study of ultimate failure load and tendon displacement.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Vaivoothpinyo Supanat, Sanguanjit Prakasit, Apivatgaroon Adinun, Pinitchanon Punnawit, Kukreja Seksan
Аннотация
INTRODUCTION/OBJECTIVES: Biceps tenodesis is a widely accepted treatment for patients with long-head biceps tendinopathy, particularly in younger, high-demand individuals. Despite its efficacy, the biomechanically optimal location for biceps tenodesis remains a subject of ongoing debate. This biomechanical study aims to compare the ultimate failure load and tendon displacement across four distinct biceps tenodesis locations in fresh-frozen human humeri to determine the strongest and most stable fixation site.
METHODS: Fresh-frozen porcine tendons were fixed using interference screws at four biceps tenodesis sites (intra-articular, biceps groove, suprapectoral, and subpectoral) on six fresh-frozen human humeri. Each construct was subjected to cyclic loading (50 N-100 N for 5000 cycles), followed by continuous load increments until failure occurred. The ultimate failure load and tendon displacement were recorded. A linear mixed model was applied to account for the multilevel model testing.
RESULTS: The mean ultimate failure loads for each group were as follows: intra-articular, 261.2 ± 78 N; biceps groove, 305 ± 113 N; suprapectoral, 337 ± 64 N; and subpectoral, 274.3 ± 108 N. Statistical analysis demonstrated a significant difference between the intra-articular and suprapectoral groups (p value = 0.03). No other pairwise comparisons in the subgroup analysis revealed significant differences.
CONCLUSIONS: The suprapectoral location demonstrated the highest ultimate failure load, with statistically significant differences compared with the intra-articular group (p value = 0.03) but not with the biceps groove and subpectoral groups. However, the results are specific to the interference screw fixation technique.
LEVEL OF EVIDENCE: III.
METHODS: Fresh-frozen porcine tendons were fixed using interference screws at four biceps tenodesis sites (intra-articular, biceps groove, suprapectoral, and subpectoral) on six fresh-frozen human humeri. Each construct was subjected to cyclic loading (50 N-100 N for 5000 cycles), followed by continuous load increments until failure occurred. The ultimate failure load and tendon displacement were recorded. A linear mixed model was applied to account for the multilevel model testing.
RESULTS: The mean ultimate failure loads for each group were as follows: intra-articular, 261.2 ± 78 N; biceps groove, 305 ± 113 N; suprapectoral, 337 ± 64 N; and subpectoral, 274.3 ± 108 N. Statistical analysis demonstrated a significant difference between the intra-articular and suprapectoral groups (p value = 0.03). No other pairwise comparisons in the subgroup analysis revealed significant differences.
CONCLUSIONS: The suprapectoral location demonstrated the highest ultimate failure load, with statistically significant differences compared with the intra-articular group (p value = 0.03) but not with the biceps groove and subpectoral groups. However, the results are specific to the interference screw fixation technique.
LEVEL OF EVIDENCE: III.