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The biomechanical performance of a new forked knotless biceps tenodesis compared to a knotless and suture anchor tenodesis

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Biomechanical comparison of three different fixation techniques for a proximal biceps tenodesis.

Methods

Eighteen human cadaver specimens were used for the testing. A tenodesis of the proximal biceps tendon was performed using a double-loaded suture anchor (5.5-mm Corkscrew, Arthrex), a knotless anchor (5.5-mm SwiveLock, Arthrex) or a forked knotless anchor (8-mm SwiveLock, Arthrex). Reconstructions were cyclically loaded for 50 cycles from 10–60 to 10–100 N. Cyclic displacement and ultimate failure loads were determined, and mode of failure was evaluated.

Results

Cyclic displacement at 60 N revealed a mean of 3.3 ± 1.1 mm for the Corkscrew, 5.4 ± 1.4 mm for the 5.5-mm SwiveLock and 2.9 ± 1.6 mm for the 8-mm forked SwiveLock. At 100 N, 5.1 ± 2.2 mm were seen for the Corkscrew anchor, 8.7 ± 2.5 mm for the 5.5-mm SwiveLock and 4.8 ± 3.3 mm for the 8-mm forked SwiveLock anchor. Significant lower cyclic displacement was seen for the Corkscrew anchor (p < 0.020) as well as the 8-mm SwiveLock anchor (p < 0.023) compared to the 5.5-mm SwiveLock anchor at 60 N. An ultimate load to failure of 109 ± 27 N was found for the Corkscrew anchor, 125 ± 25 N were measured for the 5.5-mm SwiveLock anchor, and 175 ± 42 N were found for the 8-mm forked SwiveLock anchor. Significant differences were seen between the 8-mm SwiveLock compared to the 5.5-mm SwiveLock (p < 0.044) as well as the Corkscrew anchor (p < 0.009). No significant differences were seen between the Corkscrew and the 5.5-mm SwiveLock anchor.

Conclusions

The new 8-mm forked SwiveLock anchor significantly enhances construct stability compared to a 5.5-mm double-loaded Corkscrew anchor as well as the 5.5-mm SwiveLock suture anchor. However, a restrictive postoperative rehabilitation seems to be important in all tested reconstructions in order to avoid early failure of the construct.

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Conflict of interest

No potential conflict of interest declared.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Saarland University, Kirrberger Str., Geb. 37, 66421, Homburg (Saar), Germany

    Olaf Lorbach, Christian Trennheuser, Dieter Kohn & Konstantinos Anagnostakos

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  1. Olaf Lorbach
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  2. Christian Trennheuser
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  3. Dieter Kohn
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  4. Konstantinos Anagnostakos
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Correspondence to Olaf Lorbach.

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Lorbach, O., Trennheuser, C., Kohn, D. et al. The biomechanical performance of a new forked knotless biceps tenodesis compared to a knotless and suture anchor tenodesis. Knee Surg Sports Traumatol Arthrosc 24, 2174–2180 (2016). https://doi.org/10.1007/s00167-014-3365-y

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