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

Carlos Henrique Ramos, Júlio Cezar Uili Coelho, Carlos Henrique Ramos, Júlio Cezar Uili Coelho

Abstract

Objective: To evaluate the biomechanical properties of the fixation of the long head of the biceps brachii into the humeral bone with suture anchors, interference screw, and soft tissue suture, comparing strength, highest traction load, and types of fixation failure.

Methods: Thirty fresh-frozen sheep shoulders were used, separated into three groups of ten for each technique. After fixation, the tendons were subjected to longitudinal continuous loading, obtaining load-to-failure (N) and displacement (mm).

Results: The mean load-to-failure for suture anchors was 95 ± 35.3 N, 152.7 ± 52.7 N for interference screw, and 104.7 ± 23.54 N for soft tissue technique. There was a statistically significant difference (p < 0.05), with interference screw demonstrating higher load-to-failure than suture anchor fixation (p = 0.00307) and soft tissue (p = 0.00473). The strength of interference screw was also superior when compared with the other two methods (p = 0.0000127 and p = 0.00000295, respectively). There were no differences between suture anchors and soft tissue technique regarding load-to-failure (p = 0.9420) and strength (p = 0.141).

Conclusion: Tenodesis of the long head of the biceps brachii with interference screw was stronger than the suture anchors and soft tissue techniques. The other two techniques did not differ between themselves.

Keywords: Biceps braquii; Biomechanic; Humerus; Tendons.

Figures

Fig. 1
Fig. 1
Photograph of the parts obtained by dissection; the distal insertion of the biceps in the cubitus bone (a) and the rotator cuff to the humerus (b) were maintained, Cb, cubital bone; Bc, biceps; Bg, bicipital groove; H, humerus; Rc, rotator cuff.
Fig. 2
Fig. 2
Photographs showing the humeral preparation with bone perforations (a), insertion of the anchors in the bicipital groove (b) and type of anchor used (c).
Fig. 3
Fig. 3
Drawing (a) and specimen photograph (b) showing the fixation technique with bone anchors. Ba, bone anchors; Bc, biceps; Bg, bicipital groove; H, humerus.
Fig. 4
Fig. 4
Photographs showing the fixation technique with interference screw: humeral perforation (arrow) (a), tendon repair (b) and type of screw (c) Bc, biceps; H, humerus; Arrow, humeral drilling.
Fig. 5
Fig. 5
Drawing (a) and specimen photograph (b) showing the fixation technique with interference screw. Bc, biceps; Bg, bicipital groove; Is, interference screw; H, humerus.
Fig. 6
Fig. 6
Drawing (a) and specimen photograph (b) showing the fixation technique in soft tissue. Bc, biceps; Rc, rotator cuff; H, humerus.
Fig. 7
Fig. 7
Photos showing the final assembly of the model (a), humeral fixation with transfixed steel wires (b) and direction/axis of the traction (arrows) (c) Bc, biceps; H, humerus; Arrows, direction of traction.
Fig. 8
Fig. 8
Values recorded for peak force and displacement until system failure.
Fig. 9
Fig. 9
Central data values, dispersion, and possible outliers of the long head of the biceps strength after tenodesis by bone anchors, interference screw, and soft tissue fixation without implant (n = 30).
Fig. 10
Fig. 10
Specimen photograph showing suture slip in the tendon due to tear in the test with bone anchors (arrow). Bc, biceps; H, humerus; Arrow, tendon tear.
Fig. 11
Fig. 11
Specimen photograph showing the slip of the tendon fixated with interference screw (arrow). Bc, biceps; H, humerus; Arrow, tendon slip.

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Source: PubMed

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