Mazzocca Augustus D, Bicos James, Santangelo Stephen, Romeo Anthony A, Arciero Robert A
Department of Orthopaedic Surgery, University of Connecticut Health Center, Farmington, Connecticut, Chicago, Illinois, USA.
Arthroscopy. 2005 Nov;21(11):1296-306. doi: 10.1016/j.arthro.2005.08.008.
The purpose of this study was to compare the cyclic displacement and ultimate failure strength of 4 proximal biceps tendon tenodesis fixation methods: the open subpectoral bone tunnel (SBT) biceps tenodesis, the arthroscopic suture anchor (SA) tenodesis, the open subpectoral interference screw (SIS) fixation technique, and the arthroscopic interference screw (AIS) technique.
Biomechanical experimental control.
Twenty fresh-frozen cadaver shoulders were dissected free of soft tissues, leaving the proximal humerus and the proximal biceps tendon as a free graft. Specimens were randomized to 1 of 4 groups with 5 total specimens in each group. A proximal biceps tenodesis was performed according to the techniques listed above. The specimens were mounted for an axial pull of the biceps tendon on a servohydraulic materials testing system with a 100-N load cycled at 1 Hz for 5,000 cycles, followed by an axial load to failure test. Cyclic displacement, ultimate load to failure, and site of failure were recorded for each specimen.
The mean cyclic displacement recorded for each experimental group was as follows: SBT group, 9.39 +/- 2.82 mm; AIS group, 5.26 +/- 2.60 mm; SIS group, 1.53 +/- 0.60 mm; and SA group, 3.87 +/- 2.11 mm. The mean ultimate failure loads after 5,000 cycles were as follows: SBT group, 242.4 +/- 51.33 N; AIS group, 237.6 +/- 27.58 N; SIS group, 252.4 +/- 68.63 N; and SA group, 164.8 +/- 37.47 N. Each specimen failed at the tenodesis site.
The SBT group showed statistically significant greater displacement than the other tenodesis methods. There were no statistically significant differences in ultimate failure strength between any of the biceps tenodesis methods tested.
The data serve as a guide to the surgeon performing a proximal biceps tenodesis in choosing a fixation method.
本研究旨在比较4种肱二头肌近端肌腱固定术的循环位移和极限破坏强度，这4种方法分别为：开放胸小肌下骨隧道（SBT）肱二头肌固定术、关节镜下缝线锚钉（SA）固定术、开放胸小肌下干涉螺钉（SIS）固定技术以及关节镜下干涉螺钉（AIS）技术。
生物力学实验对照研究。
对20个新鲜冷冻尸体肩关节进行软组织剥离，保留肱骨近端和肱二头肌近端肌腱作为游离移植物。将标本随机分为4组，每组5个标本。根据上述技术进行肱二头肌近端固定术。将标本安装在伺服液压材料测试系统上，对肱二头肌肌腱进行轴向拉伸，以1Hz的频率施加100N的负荷，循环5000次，随后进行轴向负荷至破坏试验。记录每个标本的循环位移、极限破坏负荷和破坏部位。
各实验组记录的平均循环位移如下：SBT组为9.39±2.82mm；AIS组为5.26±2.60mm；SIS组为1.53±0.60mm；SA组为3.87±2.11mm。5000次循环后的平均极限破坏负荷如下：SBT组为242.4±51.33N；AIS组为237.6±27.58N；SIS组为252.4±68.63N；SA组为164.8±37.47N。每个标本均在固定部位发生破坏。
SBT组的位移在统计学上显著大于其他固定方法。在所测试的任何肱二头肌固定方法之间，极限破坏强度均无统计学显著差异。
这些数据可为进行肱二头肌近端固定术的外科医生选择固定方法提供指导。
