All-Suture Anchor Techniques for Biceps Tenodesis Are Noninferior in End-Cycle Stiffness to an Interference Screw Technique; However, Secondary Outcomes, Such as Ultimate Failure Load, Yield Load, Creep, and Load-to-Failure Stiffness, Are Inferior in an Ovine Model
Purpose: To assess the biomechanical performance of 2 simplified loop-and-tack biceps tenodesis techniques, all-suture anchor and all-suture anchor with a button, compared with the interference screw technique in an ovine model. Methods: Twenty-one biceps tenodesis procedures were executed on the hu...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-10-01
|
| Series: | Arthroscopy, Sports Medicine, and Rehabilitation |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666061X24000877 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850266173318365184 |
|---|---|
| author | Kendal Carter, M.D. Emily Rogers, B.S. Nicholas J. Peterman, B.S. Vincent Wang, Ph.D. John R. Tuttle, M.D. |
| author_facet | Kendal Carter, M.D. Emily Rogers, B.S. Nicholas J. Peterman, B.S. Vincent Wang, Ph.D. John R. Tuttle, M.D. |
| author_sort | Kendal Carter, M.D. |
| collection | DOAJ |
| description | Purpose: To assess the biomechanical performance of 2 simplified loop-and-tack biceps tenodesis techniques, all-suture anchor and all-suture anchor with a button, compared with the interference screw technique in an ovine model. Methods: Twenty-one biceps tenodesis procedures were executed on the humeri and flexor digitorum profundus tendons of skeletally mature, female sheep. Limbs were evenly randomized into 2 experimental groups (all-suture anchor with or without button) and 1 control group (interference screw). Cyclic loading followed by a load-to-failure test was conducted. The primary outcome metric was end-cycle stiffness, or stiffness measured at the end of cyclic loading, because it modeled the resistance of the construct to the lower-force activities of postoperative physical therapy. Secondary metrics included ultimate failure load (UFL), yield load, creep, and load-to-failure stiffness. End-cycle stiffness difference-of-means testing was conducted with a minimal clinically important difference threshold of –15 N/mm (–1.5 kg/mm). Groups were compared using analysis of variance for all recorded variables. Results: Both the all-suture anchor techniques, without a button and with a button, were found to be noninferior in end-cycle stiffness to the interference screw technique (–5.2 N/mm [95% confidence interval, –13.6 to 3.3 N/mm] and –3.8 N/mm [95% confidence interval, –12.5 to –4.9 N/mm], respectively) with a minimal clinically important difference of –15 N/mm. The all-suture techniques showed significantly lower UFL, lower yield load, greater creep, and lower load-to-failure stiffness (P < .001, P < .001, P = .002, and P < .001, respectively). Tendon dimensions did not vary significantly across groups. Conclusions: Under subfailure loading conditions, the all-suture anchor techniques with a button and without a button showed end-cycle stiffness noninferiority to an interference screw technique; however, these techniques were inferior in all secondary outcomes, including significantly lower UFL, lower yield load, greater creep, and lower load-to-failure stiffness. Clinical Relevance: The all-suture anchor approaches with a button and without a button may retain the natural length-tension dynamics of the long head of the biceps tendon because fixation can occur before the release of the tendon origin. Additionally, they may offer a simpler and more cost-effective alternative to prevailing arthroscopic methods. |
| format | Article |
| id | doaj-art-f1de09786eee4b81bd4dee400be21f65 |
| institution | OA Journals |
| issn | 2666-061X |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroscopy, Sports Medicine, and Rehabilitation |
| spelling | doaj-art-f1de09786eee4b81bd4dee400be21f652025-08-20T01:54:15ZengElsevierArthroscopy, Sports Medicine, and Rehabilitation2666-061X2024-10-016510096010.1016/j.asmr.2024.100960All-Suture Anchor Techniques for Biceps Tenodesis Are Noninferior in End-Cycle Stiffness to an Interference Screw Technique; However, Secondary Outcomes, Such as Ultimate Failure Load, Yield Load, Creep, and Load-to-Failure Stiffness, Are Inferior in an Ovine ModelKendal Carter, M.D.0Emily Rogers, B.S.1Nicholas J. Peterman, B.S.2Vincent Wang, Ph.D.3John R. Tuttle, M.D.4Virginia Tech Carilion School of Medicine, Roanoke, Virginia, U.S.A.Department of Biomechanical Engineering and Mechanics, Virginia Tech, Blacksburg, Virginia, U.S.A.Musculoskeletal Education and Research Center, Department of Orthopaedic Surgery, Carilion Clinic, Roanoke, Virginia, U.S.A.Department of Biomechanical Engineering and Mechanics, Virginia Tech, Blacksburg, Virginia, U.S.A.Virginia Tech Carilion School of Medicine, Roanoke, Virginia, U.S.A.; Musculoskeletal Education and Research Center, Department of Orthopaedic Surgery, Carilion Clinic, Roanoke, Virginia, U.S.A.; Address correspondence to John R. Tuttle, M.D., Musculoskeletal Education and Research Center, Department of Orthopaedic Surgery, Carilion Clinic, 2331 Franklin Rd SW, Roanoke, VA 24014, U.S.A.Purpose: To assess the biomechanical performance of 2 simplified loop-and-tack biceps tenodesis techniques, all-suture anchor and all-suture anchor with a button, compared with the interference screw technique in an ovine model. Methods: Twenty-one biceps tenodesis procedures were executed on the humeri and flexor digitorum profundus tendons of skeletally mature, female sheep. Limbs were evenly randomized into 2 experimental groups (all-suture anchor with or without button) and 1 control group (interference screw). Cyclic loading followed by a load-to-failure test was conducted. The primary outcome metric was end-cycle stiffness, or stiffness measured at the end of cyclic loading, because it modeled the resistance of the construct to the lower-force activities of postoperative physical therapy. Secondary metrics included ultimate failure load (UFL), yield load, creep, and load-to-failure stiffness. End-cycle stiffness difference-of-means testing was conducted with a minimal clinically important difference threshold of –15 N/mm (–1.5 kg/mm). Groups were compared using analysis of variance for all recorded variables. Results: Both the all-suture anchor techniques, without a button and with a button, were found to be noninferior in end-cycle stiffness to the interference screw technique (–5.2 N/mm [95% confidence interval, –13.6 to 3.3 N/mm] and –3.8 N/mm [95% confidence interval, –12.5 to –4.9 N/mm], respectively) with a minimal clinically important difference of –15 N/mm. The all-suture techniques showed significantly lower UFL, lower yield load, greater creep, and lower load-to-failure stiffness (P < .001, P < .001, P = .002, and P < .001, respectively). Tendon dimensions did not vary significantly across groups. Conclusions: Under subfailure loading conditions, the all-suture anchor techniques with a button and without a button showed end-cycle stiffness noninferiority to an interference screw technique; however, these techniques were inferior in all secondary outcomes, including significantly lower UFL, lower yield load, greater creep, and lower load-to-failure stiffness. Clinical Relevance: The all-suture anchor approaches with a button and without a button may retain the natural length-tension dynamics of the long head of the biceps tendon because fixation can occur before the release of the tendon origin. Additionally, they may offer a simpler and more cost-effective alternative to prevailing arthroscopic methods.http://www.sciencedirect.com/science/article/pii/S2666061X24000877 |
| spellingShingle | Kendal Carter, M.D. Emily Rogers, B.S. Nicholas J. Peterman, B.S. Vincent Wang, Ph.D. John R. Tuttle, M.D. All-Suture Anchor Techniques for Biceps Tenodesis Are Noninferior in End-Cycle Stiffness to an Interference Screw Technique; However, Secondary Outcomes, Such as Ultimate Failure Load, Yield Load, Creep, and Load-to-Failure Stiffness, Are Inferior in an Ovine Model Arthroscopy, Sports Medicine, and Rehabilitation |
| title | All-Suture Anchor Techniques for Biceps Tenodesis Are Noninferior in End-Cycle Stiffness to an Interference Screw Technique; However, Secondary Outcomes, Such as Ultimate Failure Load, Yield Load, Creep, and Load-to-Failure Stiffness, Are Inferior in an Ovine Model |
| title_full | All-Suture Anchor Techniques for Biceps Tenodesis Are Noninferior in End-Cycle Stiffness to an Interference Screw Technique; However, Secondary Outcomes, Such as Ultimate Failure Load, Yield Load, Creep, and Load-to-Failure Stiffness, Are Inferior in an Ovine Model |
| title_fullStr | All-Suture Anchor Techniques for Biceps Tenodesis Are Noninferior in End-Cycle Stiffness to an Interference Screw Technique; However, Secondary Outcomes, Such as Ultimate Failure Load, Yield Load, Creep, and Load-to-Failure Stiffness, Are Inferior in an Ovine Model |
| title_full_unstemmed | All-Suture Anchor Techniques for Biceps Tenodesis Are Noninferior in End-Cycle Stiffness to an Interference Screw Technique; However, Secondary Outcomes, Such as Ultimate Failure Load, Yield Load, Creep, and Load-to-Failure Stiffness, Are Inferior in an Ovine Model |
| title_short | All-Suture Anchor Techniques for Biceps Tenodesis Are Noninferior in End-Cycle Stiffness to an Interference Screw Technique; However, Secondary Outcomes, Such as Ultimate Failure Load, Yield Load, Creep, and Load-to-Failure Stiffness, Are Inferior in an Ovine Model |
| title_sort | all suture anchor techniques for biceps tenodesis are noninferior in end cycle stiffness to an interference screw technique however secondary outcomes such as ultimate failure load yield load creep and load to failure stiffness are inferior in an ovine model |
| url | http://www.sciencedirect.com/science/article/pii/S2666061X24000877 |
| work_keys_str_mv | AT kendalcartermd allsutureanchortechniquesforbicepstenodesisarenoninferiorinendcyclestiffnesstoaninterferencescrewtechniquehoweversecondaryoutcomessuchasultimatefailureloadyieldloadcreepandloadtofailurestiffnessareinferiorinanovinemodel AT emilyrogersbs allsutureanchortechniquesforbicepstenodesisarenoninferiorinendcyclestiffnesstoaninterferencescrewtechniquehoweversecondaryoutcomessuchasultimatefailureloadyieldloadcreepandloadtofailurestiffnessareinferiorinanovinemodel AT nicholasjpetermanbs allsutureanchortechniquesforbicepstenodesisarenoninferiorinendcyclestiffnesstoaninterferencescrewtechniquehoweversecondaryoutcomessuchasultimatefailureloadyieldloadcreepandloadtofailurestiffnessareinferiorinanovinemodel AT vincentwangphd allsutureanchortechniquesforbicepstenodesisarenoninferiorinendcyclestiffnesstoaninterferencescrewtechniquehoweversecondaryoutcomessuchasultimatefailureloadyieldloadcreepandloadtofailurestiffnessareinferiorinanovinemodel AT johnrtuttlemd allsutureanchortechniquesforbicepstenodesisarenoninferiorinendcyclestiffnesstoaninterferencescrewtechniquehoweversecondaryoutcomessuchasultimatefailureloadyieldloadcreepandloadtofailurestiffnessareinferiorinanovinemodel |