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Biomechanical comparison of long head of biceps tenodesis with interference screw and biceps sling soft tissue
Mohammed Ahmed1, Brian T Young, Gary Bledsoe
1Departments of Orthopaedic Surgery and Biomechanical Engineering, Saint Louis University, St. Louis, MO 63110, USA.
Purpose:
The purpose of our study was to compare biomechanically a long head biceps tenodesis using an all soft tissue biceps sling technique versus an interference screw technique.
Methods:
Six paired fresh frozen shoulder specimens were separated into 2 groups. One group used an all soft tissue biceps sling technique for tenodesis. The other group used the interference screw technique for subpectoral tenodesis of the long head biceps tendon. Specimens in both groups were sequentially loaded for 200 cycles, and the difference between the initial and final displacements were recorded. Specimens were then loaded to failure. Load and mode of failure were recorded.
Results:
The mean displacement of all specimens undergoing the sling technique was significantly less than that of the interference technique at 3.0 mm (±0.80) versus 5.0 mm (±1.08) (P < .05). The biceps sling technique had a higher mean ultimate failure load (UFL) than did the interference screw tenodesis (216.9 N ± 91.6 v 171.7 N ± 101.4), although this was not statistically significant (P = .63). In the interference screw technique, 4 specimens failed at the tenodesis site by either tearing or complete pullout, whereas 2 failed at the biceps myotendinous junction. In the sling technique, 4 specimens failed at the biceps myotendinous junction, whereas one specimen tore at the tenodesis site and one detached the pectoralis tendon insertion from the humerus. One specimen in the biceps sling technique and 2 specimens in the interference screw technique failed before completing all 200 cycles.
Conclusions:
The results of this biomechanical study show that the biceps sling technique has construct stability similar to that of the interference screw technique.
Clinical Relevance:
The biceps sling may be a reasonable alternative for treating symptomatic pathologic conditions of the long head biceps tendon.
