Suprapectoral biceps tenodesis: A biomechanical comparison of a new “soft anchor” tenodesis technique versus interference screw biceps tendon fixation

Biomechanical evaluation of the long head of the biceps brachii tendon fixed by three techniques: a sheep model

“…Nevertheless, according to the literature, the mean LTF for bone anchors is 188 N, ranging from 68.5 N to 310 N. For IS, the mean is 241 N (159–480 N) and for soft tissue fixation, the mean is 179 N (142–216 N). 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 In the present study, these values were 95 N, 152.7 N, and 104.7 N, respectively; when compared separately with the literature, these values were lower for the three methods. This difference can be attributed to the different methodologies adopted, or to factors such as types of specimens (human cadavers, sheep, pigs), bone density, nature of the implants (metal, bioabsorbable), different types of sutures and bone anchors, frequency in the displacement of traction throughout the tendon, or surgical technique.…”

“… 14 Anchors prepared with double wire have also showed greater resistance. 21 Another factor is the difference observed between cyclical or continuous tensile tests. The present study followed a similar model to that described by Bradbury et al, 18 who tested biceps resistance with continuous traction and justified that fixation failures would occur postoperatively in a single, sudden flexion or supination movement of the forearm, unlike the plastic deformation simulated by cyclic testing.…”

“… 10 , 12 , 15 , 16 , 22 Other studies observed no statistical difference between these techniques, despite the fact that the LTF was always higher for fixation with IS. 11 , 14 , 19 , 20 , 21 , 23 Regarding soft tissue fixation, two biomechanical studies that compared bone anchors with IS were retrieved in the literature, and no statistical difference in resistance was observed in both studies. Nevertheless, in the second study, the soft tissue suture was made in the tendon of the pectoralis major muscle with more than two stitches, which may explain the higher LTF when compared with IS.…”

“…There is no consensus in the literature regarding which fixation method is more resistant. 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 This study aimed to compare three techniques for fixation of the LHBBT in the humerus (bone anchors, IS, and soft tissue suture) regarding resistance of the fixation, load-to-failure (LTF), and system failure.…”

Subpectoral Biceps Tenodesis: Interference Screw and Cortical Button Fixation

“…Biomechanical studies have been undertaken, with varying results, regarding superiority of fixation techniques, although most seem to be adequate. 18 , 19 , 20 , 21 , 22 Buchholz et al. 18 evaluated intramedullary cortical button fixation compared with interference screw usage and found similar results in regard to stiffness and ultimate failure loads, suggesting that both can be used for subpectoral fixation.…”