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Published in: Journal of Orthopaedic Science 5/2013

01-09-2013 | Original Article

Biomechanical strain characteristics of soft tissue biceps tenodesis and bony tenodesis

Authors: Steven D. Levin, David S. Wellman, Charley Liu, Yue Li, Yupeng Ren, Nirav A. Shah, Li-Qun Zhang

Published in: Journal of Orthopaedic Science | Issue 5/2013

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Abstract

Background

Biomechanical analysis of biceps tenodesis procedures has historically focused on load to failure models. Minimal data exists for the analysis of biomechanical strain properties of the biceps tendon in a sub-failure, physiologic cadaver model.

Hypothesis

Tendon strain characteristics are different between bony and soft tissue tenodesis surgery, and the soft tissue tenodesis procedure reproduces a strain pattern more similar to the native biceps tendon.

Methods

Eight fresh frozen cadaver upper extremities were mounted onto a custom device that controls shoulder abduction and rotation. Strain on the tendon was measured using a differential variable reluctance transducer as the arm was moved through cycles of abduction and external rotation. Each arm was mounted once, and all 3 testing procedures were performed on each of the 8 specimens. Statistical analysis was completed using ANOVA, followed by multiple comparisons with Bonferroni correction.

Results

The bony tenodesis model placed higher strain on the biceps tendon than the soft tissue tenodesis (p = 0.025). Also, the bony tenodesis model increased the strain on the biceps tendon when compared to the native tendon (p = 0.031). In contrast, the soft tissue tenodesis did not significantly alter strain when compared to the native tendon (p = 0.089).

Conclusion

The soft tissue tenodesis procedure better maintained the native strain environment when compared to the bony tenodesis using an interference screw. Due to this closer approximation of native biceps tendon biomechanics, the soft tissue procedure may be more preferable clinically than the bony tenodesis.
Level of Evidence: 1, Controlled Laboratory Study.
Literature
1.
go back to reference Hsu AR, Ghodadra NS, Provencher CDRMT, Lewis PB, Bach BR. Biceps tenotomy versus tenodesis: a review of clinical outcomes and biomechanical results. J Shoulder Elbow Surg. 2011;20:326–32.PubMedCrossRef Hsu AR, Ghodadra NS, Provencher CDRMT, Lewis PB, Bach BR. Biceps tenotomy versus tenodesis: a review of clinical outcomes and biomechanical results. J Shoulder Elbow Surg. 2011;20:326–32.PubMedCrossRef
2.
go back to reference Slenker NR, Lawson K, Ciccotti MG, Dodson CC, Cohen SB. Biceps tenotomy versus tenodesis: clinical outcomes. J Arthrosc Relat Surg. 2012;28:576–82.CrossRef Slenker NR, Lawson K, Ciccotti MG, Dodson CC, Cohen SB. Biceps tenotomy versus tenodesis: clinical outcomes. J Arthrosc Relat Surg. 2012;28:576–82.CrossRef
3.
go back to reference Kelly AM, Drakos MC, Fealy S, Taylor SA, O’Brien SJ. Arthroscopic release of the long head of the biceps tendon: functional outcome and clinical results. Am J Sports Med. 2005;33:208–13.PubMedCrossRef Kelly AM, Drakos MC, Fealy S, Taylor SA, O’Brien SJ. Arthroscopic release of the long head of the biceps tendon: functional outcome and clinical results. Am J Sports Med. 2005;33:208–13.PubMedCrossRef
4.
go back to reference Mariani EM, Cofield RH, Askew LJ, Li GP, Chao EY. Rupture of the tendon of the long head of the biceps brachii. Surgical versus nonsurgical treatment. Clin Orthop Relat Res. 1988;228:233–9.PubMed Mariani EM, Cofield RH, Askew LJ, Li GP, Chao EY. Rupture of the tendon of the long head of the biceps brachii. Surgical versus nonsurgical treatment. Clin Orthop Relat Res. 1988;228:233–9.PubMed
5.
go back to reference Boileau P, Krishnan SG, Coste JS, Walch G. Arthroscopic biceps tenodesis: a new technique using bioabsorbable interference screw fixation. Arthroscopy. 2002;18:1002–12.PubMedCrossRef Boileau P, Krishnan SG, Coste JS, Walch G. Arthroscopic biceps tenodesis: a new technique using bioabsorbable interference screw fixation. Arthroscopy. 2002;18:1002–12.PubMedCrossRef
6.
go back to reference Becker DA, Cofield RH. Tenodesis of the long head of the biceps brachii for chronic bicipital tendinitis. Long-term results. J Bone Joint Surg Am. 1989;71:376–81.PubMed Becker DA, Cofield RH. Tenodesis of the long head of the biceps brachii for chronic bicipital tendinitis. Long-term results. J Bone Joint Surg Am. 1989;71:376–81.PubMed
7.
go back to reference Post M, Benca P. Primary tendinitis of the long head of the biceps. Clin Orthop Relat Res. 1989;246:117–25.PubMed Post M, Benca P. Primary tendinitis of the long head of the biceps. Clin Orthop Relat Res. 1989;246:117–25.PubMed
8.
go back to reference Nord KD, Smith GB, Mauck BM. Arthroscopic biceps tenodesis using suture anchors through the subclavian portal. Arthroscopy. 2005;21:248–52.PubMedCrossRef Nord KD, Smith GB, Mauck BM. Arthroscopic biceps tenodesis using suture anchors through the subclavian portal. Arthroscopy. 2005;21:248–52.PubMedCrossRef
9.
go back to reference Dines D, Warren RF, Inglis AE. Surgical treatment of lesions of the long head of the biceps. Clin Orthop Relat Res. 1982;164:165–71.PubMed Dines D, Warren RF, Inglis AE. Surgical treatment of lesions of the long head of the biceps. Clin Orthop Relat Res. 1982;164:165–71.PubMed
10.
go back to reference Elkousy HA, Fluhme DJ, O’Connor DP, Rodosky MW. Arthroscopic biceps tenodesis using the percutaneous, intra-articular trans-tendon technique: preliminary results. Orthopedics. 2005;28:1316–9.PubMed Elkousy HA, Fluhme DJ, O’Connor DP, Rodosky MW. Arthroscopic biceps tenodesis using the percutaneous, intra-articular trans-tendon technique: preliminary results. Orthopedics. 2005;28:1316–9.PubMed
11.
go back to reference Richards DP, Burkhart SS. A biomechanical analysis of two biceps tenodesis fixation techniques. Arthroscopy. 2005;21:861–6.PubMedCrossRef Richards DP, Burkhart SS. A biomechanical analysis of two biceps tenodesis fixation techniques. Arthroscopy. 2005;21:861–6.PubMedCrossRef
12.
go back to reference Golish SR, Caldwell PE 3rd, Miller MD, Singanamala N, Ranawat AS, Treme G, Pearson SE, Costic R, Sekiya JK. Interference screw versus suture anchor fixation for subpectoral tenodesis of the proximal biceps tendon: a cadaveric study. Arthroscopy. 2008;24:1103–8.PubMedCrossRef Golish SR, Caldwell PE 3rd, Miller MD, Singanamala N, Ranawat AS, Treme G, Pearson SE, Costic R, Sekiya JK. Interference screw versus suture anchor fixation for subpectoral tenodesis of the proximal biceps tendon: a cadaveric study. Arthroscopy. 2008;24:1103–8.PubMedCrossRef
13.
go back to reference Kusma M, Dienst M, Eckert J, Steimer O, Kohn D. Tenodesis of the long head of biceps brachii: cyclic testing of five methods of fixation in a porcine model. J Shoulder Elbow Surg. 2008;17:967–73.PubMedCrossRef Kusma M, Dienst M, Eckert J, Steimer O, Kohn D. Tenodesis of the long head of biceps brachii: cyclic testing of five methods of fixation in a porcine model. J Shoulder Elbow Surg. 2008;17:967–73.PubMedCrossRef
14.
go back to reference Lopez-Vidriero E, Costic RS, Fu FH, Rodosky MW. Biomechanical evaluation of 2 arthroscopic biceps tenodeses: double-anchor versus percutaneous intra-articular transtendon (PITT) techniques. Am J Sports Med. 2010;38:146–52.PubMedCrossRef Lopez-Vidriero E, Costic RS, Fu FH, Rodosky MW. Biomechanical evaluation of 2 arthroscopic biceps tenodeses: double-anchor versus percutaneous intra-articular transtendon (PITT) techniques. Am J Sports Med. 2010;38:146–52.PubMedCrossRef
15.
go back to reference Sekiya JK, Elkousy HA, Rodosky MW. Arthroscopic biceps tenodesis using the percutaneous intra-articular transtendon technique. Arthroscopy. 2003;19:1137–41.PubMedCrossRef Sekiya JK, Elkousy HA, Rodosky MW. Arthroscopic biceps tenodesis using the percutaneous intra-articular transtendon technique. Arthroscopy. 2003;19:1137–41.PubMedCrossRef
16.
17.
go back to reference Frost A, Zafar MS, Maffulli N. Tenotomy versus tenodesis in the management of pathologic lesions of the tendon of the long head of the biceps brachii. Am J Sports Med. 2009;37:828–33.PubMedCrossRef Frost A, Zafar MS, Maffulli N. Tenotomy versus tenodesis in the management of pathologic lesions of the tendon of the long head of the biceps brachii. Am J Sports Med. 2009;37:828–33.PubMedCrossRef
18.
go back to reference Jayamoorthy T, Field JR, Costi JJ, Martin DK, Stanley RM, Hearn TC. Biceps tenodesis: a biomechanical study of fixation methods. J Shoulder Elbow Surg. 2004;13:160–4.PubMedCrossRef Jayamoorthy T, Field JR, Costi JJ, Martin DK, Stanley RM, Hearn TC. Biceps tenodesis: a biomechanical study of fixation methods. J Shoulder Elbow Surg. 2004;13:160–4.PubMedCrossRef
19.
go back to reference Ozalay M, Akpinar S, Karaeminogullari O, Balcik C, Tasci A, Tandogan RN, Gecit R. Mechanical strength of four different biceps tenodesis techniques. Arthroscopy. 2005;21:992–8.PubMedCrossRef Ozalay M, Akpinar S, Karaeminogullari O, Balcik C, Tasci A, Tandogan RN, Gecit R. Mechanical strength of four different biceps tenodesis techniques. Arthroscopy. 2005;21:992–8.PubMedCrossRef
20.
go back to reference Mazzocca AD, Bicos J, Santangelo S, Romeo AA, Arciero RA. The biomechanical evaluation of four fixation techniques for proximal biceps tenodesis. Arthroscopy. 2005;21:1296–306.PubMedCrossRef Mazzocca AD, Bicos J, Santangelo S, Romeo AA, Arciero RA. The biomechanical evaluation of four fixation techniques for proximal biceps tenodesis. Arthroscopy. 2005;21:1296–306.PubMedCrossRef
Metadata
Title
Biomechanical strain characteristics of soft tissue biceps tenodesis and bony tenodesis
Authors
Steven D. Levin
David S. Wellman
Charley Liu
Yue Li
Yupeng Ren
Nirav A. Shah
Li-Qun Zhang
Publication date
01-09-2013
Publisher
Springer Japan
Published in
Journal of Orthopaedic Science / Issue 5/2013
Print ISSN: 0949-2658
Electronic ISSN: 1436-2023
DOI
https://doi.org/10.1007/s00776-013-0429-7

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