Using Interconnected Knotless Anchor for Suprapectoral Biceps Tenodesis Could Offer Improved Biomechanical Properties in a Cadaveric Model

2020 ◽  
Vol 36 (8) ◽  
pp. 2047-2054 ◽  
Author(s):  
Fa-Chuan Kuan ◽  
Kai-Lan Hsu ◽  
Joe-Zhi Yen ◽  
Miin-Jye Wen ◽  
Ming-Long Yeh ◽  
...  
Keyword(s):  
Biomechanical Properties ◽  
Biceps Tenodesis ◽  
Knotless Anchor ◽  
Cadaveric Model

scholarly journals Biomechanical comparison of subscapularis peel and lesser tuberosity osteotomy for double-row subscapularis repair technique in a cadaveric arthroplasty model

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Mandeep S. Virk ◽  
Saleh S. Aiyash ◽  
Rachel M. Frank ◽  
Christopher S. Mellano ◽  
Elizabeth F. Shewman ◽  
...  
Keyword(s):  
Soft Tissues ◽  
Maximum Load ◽  
Biomechanical Properties ◽  
Level Of Evidence ◽  
Double Row ◽  
Lesser Tuberosity ◽  
Bone Interface ◽  
Tendon Suture ◽  
Fresh Frozen ◽  
Cadaveric Model

Abstract Introduction Management of the subscapularis during shoulder arthroplasty is controversial. The purpose of this study was to compare the biomechanical performance of subscapularis peel (SP) and lesser tuberosity osteotomy (LTO) in a cadaveric model. Methods The subscapularis and proximal humerus were dissected from all soft tissues in 21 fresh-frozen human cadaveric shoulders and randomized to undergo SP, LTO, or standard subscapularis tenotomy (ST, control). For SP and LTO, six #5 sutures were passed through eyelets in the implant (on lateral border and through drill holes in bicipital groove [2] and under trunion [4]). Double-row repair was performed using two lateral row transosseous sutures and four medial row sutures through the tendon (SP) or osseotendinous junction (LTO). Biomechanical properties and mode of failure were tested. Results There were no significant differences in elongation amplitude, cyclic elongation, or maximum load to failure between the three groups (P > 0.05). Mean stiffness was significantly higher in LTO (P = 0.009 vs. SP and ST). In the ST group, 7/7 specimens failed at the tendon-suture interface. For SP, 4/7 failed at the tendon-suture interface, one at the suture-bone interface, one fractured around the implant stem, and one at the knots. For LTO, 3/7 failed at the tendon-suture interface, two at the suture-bone interface and two fractured around the implant stem. Conclusions In this cadaveric model, subscapularis repair via ST, SP, and LTO techniques was biomechanically equivalent. Additional studies are needed to confirm these findings and determine the influence of biologic healing on healing rates and clinical outcomes. Level of evidence N/a, biomechanical laboratory study

Biomechanical properties of suprapectoral biceps tenodesis: double knotless screw fixation is superior to single knotless screw fixation

2018 ◽  
Vol 138 (8) ◽  
pp. 1127-1134 ◽  
Author(s):  
Chih-Kai Hong ◽  
Chih-Hsun Chang ◽  
Florence L. Chiang ◽  
I-Ming Jou ◽  
Ping-Hui Wang ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Biomechanical Properties ◽  
Biceps Tenodesis

scholarly journals All-suture anchor and unicortical button show comparable biomechanical properties for onlay subpectoral biceps tenodesis

2020 ◽  
Vol 4 (4) ◽  
pp. 833-837
Author(s):  
Alexander Otto ◽  
Sebastian Siebenlist ◽  
Joshua B. Baldino ◽  
Matthew Murphy ◽  
Lukas N. Muench ◽  
...  
Keyword(s):  
Suture Anchor ◽  
Biomechanical Properties ◽  
Biceps Tenodesis ◽  
Subpectoral Biceps Tenodesis

scholarly journals Initial Biomechanical Properties of Transtibial Meniscal Root Repair are Improved By Using a Knotless Anchor as a Post-Insertion Tensioning Device

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Maria Prado-Novoa ◽  
Ana Perez-Blanca ◽  
Alejandro Espejo-Reina ◽  
Maria Jose Espejo-Reina ◽  
Alejandro Espejo-Baena
Keyword(s):  
Biomechanical Properties ◽  
Meniscal Root ◽  
Knotless Anchor ◽  
Root Repair

Similar clinical outcomes of biceps tenodesis with various kinds of fixation techniques: a systematic review

2019 ◽  
Vol 4 (6) ◽  
pp. 328-337
Author(s):  
Chairit Lohakitsathian ◽  
Felix Mayr ◽  
Julian Mehl ◽  
Sebastian Siebenlist ◽  
Andreas B Imhoff
Keyword(s):  
Soft Tissue ◽  
Clinical Outcomes ◽  
Screw Fixation ◽  
Interference Screw ◽  
Complication Rates ◽  
Biceps Tenodesis ◽  
Knotless Anchor ◽  
Fixation Techniques ◽  
Interference Screw Fixation ◽  
Anchor Suture

ImportanceThere are many different ways to fix the long head of biceps (LHB) tendon to the proximal humerus but there is still no consensus about clinical outcomes on how each fixation technique relates to biceps tenodesis.ObjectiveThe purpose of this review was to systematically review subjective outcomes, patient and physical driven and surgical complications following tenodesis of the LHB tendon comparing different fixation techniques.Evidence reviewA systematic search for articles on the biceps tenodesis technique with reports of at least one in three aspect outcomes was carried out from January 2013 to November 2018. PubMed, Embase and the Cochrane Library were the databases used for the literature review. The different surgical methods were compared by the number of studies that had significantly improved mean postoperative scores compared with preoperative scores. Besides this, the means of postoperative subjective outcome (Visual Analogue Scale for pain), and patient and physical driven (American Shoulder and Elbow Surgeons Score and the Constant-Murley Score) scores were also reported. Additionally, the complication rate of each technique was evaluated.FindingsFifty studies out of 761 were included. The interference screw fixation without tie over screw, interference screw fixation with tie over screw, single anchor suture, knotless anchor suture and soft tissue tenodesis techniques had more than one study that reported significant improvement in postoperative subjective, patient and physical driven scores compared with preoperative scores. There was no significant difference in clinical outcomes of the interference screw without tie over screw compared with the single anchor suture and interference screw with tie over screw techniques. Soft tissue tenodesis, single anchor suture and knotless anchor suture showed higher complication rates in comparison with other methods.Conclusion and relevanceAll five techniques mentioned above (interference screw fixation without tie over screw, interference screw fixation with tie over screw, single anchor suture, knotless anchor suture and soft tissue tenodesis) provided significant improvement in subjective outcomes, and patient and physical driven outcomes compared with the preoperative status. The soft tissue tenodesis, single anchor suture and knotless anchor suture techniques showed higher complication rates in comparison with other methods.Level of evidenceLevel IV.

Ex Vivo Biomechanical Assessment of a Novel Multi-Strand Repair of Canine Tendon Lacerations

2021 ◽  
Author(s):  
Chiara P. Curcillo ◽  
Daniel J. Duffy ◽  
Yi-Jen Chang ◽  
George E. Moore
Keyword(s):  
Ex Vivo ◽  
Biomechanical Properties ◽  
Clinical Implementation ◽  
Gap Formation ◽  
Repair Site ◽  
Biomechanical Assessment ◽  
Failure Loads ◽  
Pull Through ◽  
Cadaveric Model

Abstract Objective This study aimed to evaluate the effect of increasing the number of suture strands traversing the transection site, level of suture purchase and depth of suture penetrance on the biomechanical properties of repaired gastrocnemius tendons. Study Design Thirty-eight adult cadaveric gastrocnemius tendons were randomized, transected and repaired with either two-, four- or six-strand locking multi-level repair. Tensile loads required to create a 1 and 3 mm gap, yield, peak and failure loads and failure mode were analysed. Significance was set at p < 0.05. Results Mean ± standard deviation yield, peak and failure force for six-strand repairs was 90.6 ± 22.1 N, 111.4 ± 15.2 N and 110.3 ± 15.1 N respectively. This was significantly greater compared with both four-strand (55.0 ± 8.9 N, 72.9 ± 7.8 N and 72.1 ± 8.2 N) and two-strand repairs (24.7 ± 8.3 N, 36.5 ± 6.0 N and 36.1 ± 6.3 N) respectively (p < 0.001). Occurrence of 3 mm gap formation was significantly less using six-strand repairs (p < 0.001). Mode of failure did not differ between groups with all repairs (36/36; 100%) failing by suture pull-through. Conclusion Pattern modification by increasing the number of suture strands crossing the repair site, increasing points of suture purchase from the transection site and depth of suture penetrance is positively correlated with repair site strength while significantly reducing the occurrence of gap formation in a canine cadaveric model. Additional studies in vivo are recommended to evaluate their effect on tendinous healing, blood supply and glide resistance prior to clinical implementation.

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