The new LassoLoop360° technique for biomechanically superior tissue grip

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomedical Engineering

Background:

• Suprapectoral tenodesis is a common surgical treatment for long head of the biceps brachii (LHBB) tendon pathologies.
• Currently, no definitive Gold Standard treatment exists for LHBB tendon issues.

Purpose of the Study:

• To introduce and evaluate the arthroscopic LassoLoop360 (LL360) technique for secure LHBB tendon fixation.
• To hypothesize that the LL360 technique offers superior biomechanical properties over the simple Lasso Loop (SLL) technique.

Main Methods:

• Twenty-two porcine superficial flexor digitorum tendons were prepared using either the SLL or LL360 technique with No. 2 suture.
• Constructs were tested for displacement under cyclic loading (5-30 N), ultimate load-to-failure (ULTF), and stiffness.

Main Results:

• The LL360 technique demonstrated significantly less displacement (1.67 ± 0.37 mm) compared to SLL (2.25 ± 0.51 mm).
• ULTF was significantly higher for LL360 (168.6 ± 29.6 N) versus SLL (124.1 ± 25.8 N).
• LL360 constructs exhibited significantly greater stiffness (19.1 ± 1.0 N/mm) than SLL (13.1 ± 0.9 N/mm), with reduced suture pull-through failure.

Conclusions:

• The LL360 technique provides superior biomechanical characteristics at the tendon-suture interface compared to the SLL technique.
• This enhanced fixation may be crucial during the initial healing phase, addressing the most vulnerable part of the construct.
• The LL360 technique shows promise for improving outcomes in arthroscopic suprapectoral biceps tenodesis.