A Radiostereometric Analysis of Tendon Migration After Arthroscopic and Mini-Open Biceps Tenodesis: Interference...

Area of Science:

• Orthopedic surgery
• Sports medicine
• Biomechanical analysis

Background:

• Clinical outcomes for arthroscopic and open biceps tenodesis (BT) are comparable.
• Investigating fixation methods is crucial for optimizing BT procedures.

Purpose of the Study:

• To compare postoperative migration of BT constructs using interference screws (IS) versus single-suture suture anchors (SSSAs).
• To evaluate migration differences between arthroscopic suprapectoral BT (ASPBT) and open subpectoral BT (OSPBT) techniques.

Main Methods:

• Prospective cohort study (Level 2 evidence) measuring distal biceps tendon migration via radiostereometric analysis.
• Compared IS and SSSA fixation in both ASPBT and OSPBT procedures.
• Assessed patient-reported outcome measures (PROMs) preoperatively and at final follow-up.

Main Results:

• Interference screw fixation demonstrated the least tendon migration, with no significant difference between open and arthroscopic approaches.
• Single-suture suture anchor fixation resulted in significantly greater migration compared to IS at 1 week and 3 months.
• Two-suture anchor fixation showed greater migration than IS at 1 week but not at 3 months. Popeye deformity occurred only with suture anchor fixation.

Conclusions:

• Interference screw fixation is associated with minimal tendon migration in biceps tenodesis, irrespective of surgical approach.
• Single-suture suture anchors lead to increased migration; using two or more anchors may mitigate this effect.
• Despite migration differences, patient-reported outcomes were similar across all fixation groups.