Richards David P, Burkhart Stephen S
The San Antonio Orthopaedic Group, San Antonio, Texas, USA.
Arthroscopy. 2005 Jul;21(7):861-6. doi: 10.1016/j.arthro.2005.03.020.
To assess and compare the biomechanical properties and load-to-failure of 2 biceps tenodesis fixation techniques, interference screw fixation and double suture anchor fixation.
Biomechanical study.
Eleven fresh-frozen human cadaveric specimens were used in this study. A biceps tenodesis was performed using 1 of 2 techniques, interference screw fixation or double suture anchor fixation. A 7-mm interference screw was used in 5 cadaveric trials. A double suture anchor technique was performed in 6 cadaveric specimens. The tenodesis construct in each specimen was loaded to failure using a Servohydraulic materials test system (MTS Model 858; Bionix, MTS Corp, Minneapolis, MN). Each specimen was loaded at 5 mm/second with a preload of 5 N with the vector of pull distally in line with the long axis of the humerus. Each specimen was then loaded until failure of the repair occurred. Statistical analysis of the interference screw group compared with the suture anchor group was performed using a Student t test.
The mode of failure of the interference screw group was variable, but the suture anchor group consistently failed at the anchor or anchor eyelet. The average pullout strength of the suture anchor group was 135.5 +/- 37.8 N whereas the failure load in the interference group was 233.5 +/- 55.5 N. The interference group had a significantly greater resistance to pullout than the suture anchor group (P = .007).
Based on these results, a biceps tenodesis using an interference screw will provide greater fixation strength than a biceps tenodesis performed with a double suture anchor technique.
The surgeon treating biceps tenodesis may wish to choose a fixation technique with higher initial strength (interference screw instead of double suture anchor) to lessen the chance of early failure, particularly if the patient begins early active elbow flexion.
评估并比较两种肱二头肌肌腱固定技术（干涉螺钉固定和双缝线锚钉固定）的生物力学特性和失效负荷。
生物力学研究。
本研究使用了11个新鲜冷冻的人体尸体标本。采用干涉螺钉固定或双缝线锚钉固定这两种技术中的一种进行肱二头肌肌腱固定。在5个尸体试验中使用了7毫米的干涉螺钉。在6个尸体标本上进行了双缝线锚钉技术操作。使用伺服液压材料测试系统（MTS 858型；Bionix，MTS公司，明尼阿波利斯，明尼苏达州）对每个标本中的肌腱固定结构加载直至失效。每个标本以5毫米/秒的速度加载，预加载力为5牛，拉力方向沿肱骨长轴远端。然后对每个标本加载直至修复失效。使用学生t检验对干涉螺钉组和缝线锚钉组进行统计学分析。
干涉螺钉组的失效模式各不相同，但缝线锚钉组始终在锚钉或锚钉孔眼处失效。缝线锚钉组的平均拔出强度为135.5±37.8牛，而干涉组的失效负荷为233.5±55.5牛。干涉组的拔出阻力明显大于缝线锚钉组（P = 0.007）。
基于这些结果，使用干涉螺钉进行肱二头肌肌腱固定比使用双缝线锚钉技术进行的肱二头肌肌腱固定具有更大的固定强度。
治疗肱二头肌肌腱固定的外科医生可能希望选择初始强度更高的固定技术（干涉螺钉而非双缝线锚钉）以降低早期失效的几率，特别是如果患者早期开始主动屈肘。
