Department of Orthopaedic Surgery, National Cheng Kung University Hospital, Tainan, Taiwan.
Arthroscopy. 2013 Sep;29(9):1498-505. doi: 10.1016/j.arthro.2013.06.013.
The purpose of this biomechanical study was to compare the ultimate failure strength, stiffness, cyclic displacement, and failure displacement of 5 different proximal biceps tenodesis fixation techniques, specifically comparing wedge tenodesis with the other 4 techniques.
Forty cadaveric shoulders underwent 1 of 5 long head of the biceps tenodesis techniques and were cyclically tested to failure by use of tensile forces applied parallel to the longitudinal axis of the humerus. A preload at 5 N was applied for 2 minutes, followed by cyclical loading for 500 cycles from 5 to 70 N at 1 Hz and a pull-to-failure test at 1 mm/s. The techniques studied were wedge tenodesis, suture anchor fixation, suprapectoral interference screw fixation, T-wedge tenodesis, and the percutaneous intra-articular transtendon (PITT) technique. Cyclic displacement, failure displacement, and stiffness were calculated.
The wedge tenodesis technique had an ultimate failure load similar to interference screw fixation and a greater ultimate failure load and stiffness than the suture anchor, PITT, and T-wedge techniques (P < .05).
In this biomechanical study, wedge tenodesis was found to have an ultimate failure load similar to interference screw fixation and a greater ultimate failure load and stiffness than the suture anchor, PITT, and T-wedge techniques.
On biomechanical testing, wedge tenodesis compares favorably with other techniques and may be a useful clinical option for proximal biceps tenodesis.
本生物力学研究的目的是比较 5 种不同肱二头肌近侧止点固定技术(具体比较楔入式与其他 4 种技术)的最终失效强度、刚度、循环位移和失效位移。
40 个尸体肩进行了 1 种肱二头肌长头肌腱固定技术,通过平行于肱骨长轴施加的张力进行循环至失效测试。先施加 5N 的预载 2 分钟,然后以 1Hz 的频率从 5N 至 70N 循环加载 500 次,最后以 1mm/s 的速度进行拉断测试。研究的技术有楔入式、缝线锚定固定、肩上方干扰螺钉固定、T 型楔入式和经皮关节内腱内(PITT)技术。计算循环位移、失效位移和刚度。
楔入式技术的最终失效负荷与干扰螺钉固定相似,而最终失效负荷和刚度均大于缝线锚定、PITT 和 T 型楔入式技术(P<0.05)。
在这项生物力学研究中,楔入式技术的最终失效负荷与干扰螺钉固定相似,而最终失效负荷和刚度均大于缝线锚定、PITT 和 T 型楔入式技术。
在生物力学测试中,楔入式技术与其他技术相比具有优势,可能是肱二头肌近侧止点固定的一种有用的临床选择。