Kinnard Matthew J, Tran Jeremy D, Voinier Steven D, Colantonio Donald F, Murphy Timothy P, Mescher Patrick K, Donohue Michael A, Helgeson Melvin D, Tucker Christopher J
Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland, U.S.A.
Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, Tennessee, U.S.A.
Arthrosc Sports Med Rehabil. 2024 Jul 8;6(6):100966. doi: 10.1016/j.asmr.2024.100966. eCollection 2024 Dec.
To evaluate the maximal load to failure, cyclic displacement, stiffness, and modes of failure of onlay subpectoral biceps tenodesis with an intramedullary unicortical metal button (MB) versus an inlay, all-suture Caspari-Weber (CW) technique.
Sixteen matched paired human cadaveric proximal humeri were randomly allocated for subpectoral BT with either CW or MB using a high-strength suture (N = 16; 8 male, 8 female, mean age = 82.5 years, range 62-99 years). Specimens were tested on a servohydraulic mechanical testing apparatus under cyclic load for 1,000 cycles and then loaded to failure. Maximal load to failure, displacement, construct stiffness, and mode of failure were compared.
There was no significant difference between groups when comparing construct stiffness, creep displacement, or displacement at ultimate load. The maximal load to failure for the CW technique was greater than the unicortical MB (588.36 ± 149.06 N vs 375.83 ± 131.4 N, = .014).
In this study, the all-suture CW biceps tenodesis technique had a greater maximal load to failure than the onlay unicortical MB technique while having similar construct displacement and stiffness. The CW subpectoral biceps tenodesis may offer a lower cost alternative with a mechanically robust fixation when performing an open subpectoral biceps tenodesis.
This cadaveric biomechanical study can help guide surgeons when selecting a fixation technique for biceps tenodesis.
评估采用髓内单皮质金属纽扣（MB）的胸肌下肱二头肌镶嵌术与镶嵌式全缝线Caspari-Weber（CW）技术在失效时的最大负荷、循环位移、刚度及失效模式。
16对匹配的人类尸体近端肱骨被随机分配，使用高强度缝线，分别采用CW或MB技术进行胸肌下肱二头肌固定术（N = 16；8例男性，8例女性，平均年龄 = 82.5岁，范围62 - 99岁）。标本在伺服液压机械测试装置上进行1000次循环的循环加载，然后加载至失效。比较失效时的最大负荷、位移、结构刚度及失效模式。
比较结构刚度、蠕变位移或极限负荷下的位移时，两组之间无显著差异。CW技术的失效最大负荷大于单皮质MB技术（588.36 ± 149.06 N对375.83 ± 131.4 N，P = .014）。
在本研究中，全缝线CW肱二头肌固定术在失效时的最大负荷大于镶嵌式单皮质MB技术，同时具有相似的结构位移和刚度。在进行开放性胸肌下肱二头肌固定术时，CW胸肌下肱二头肌固定术可能提供一种成本较低且机械固定稳固的替代方法。
这项尸体生物力学研究可帮助外科医生在选择肱二头肌固定术的固定技术时提供指导。
