Distal Biceps Tendon Repair: A Biomechanical Comparison of Intact Tendon and 2 Repair Techniques
Background A variety of techniques have been described for distal biceps tendon reattachment—bone tunnel with transosseous sutures, suture anchors, and interference screw techniques. Hypothesis There will be no significant difference between the mean failure strength, maximum strength, and stiffness...
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| Veröffentlicht in: | The American journal of sports medicine 2006-06, Vol.34 (6), p.968-974 |
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| creator | Idler, Cary S. Montgomery, William H. Lindsey, Derek P. Badua, Peter A. Wynne, Garnet F. Yerby, Scott A. |
| description | Background
A variety of techniques have been described for distal biceps tendon reattachment—bone tunnel with transosseous sutures, suture anchors, and interference screw techniques.
Hypothesis
There will be no significant difference between the mean failure strength, maximum strength, and stiffness of the intact specimen and repair techniques tested: bone tunnel with transosseous sutures and interference screw.
Study Design
Controlled laboratory study.
Methods
Nine matched pairs of fresh-frozen human cadaveric elbows were prepared. The intact tendon was pulled from the radial tuberosity; the right and left elbows were randomized to bone tunnels with transosseous sutures or interference screw repair techniques. The repaired specimens were pulled using the same regimen for the intact tendon. Failure strength, maximum strength, and stiffness were measured and compared.
Results
The mean failure strength, maximum strength, and stiffness of intact tendons were 204.3 ± 76.9 N, 221.7 ± 65.9 N, and 30.1 ± 12.4 N/mm, respectively; for the interference screw specimens, 178.0 ± 54.5 N, 192.1 ± 53.1 N, and 30.4 ± 9.5 N/mm, respectively; and for the bone tunnel specimens, 124.9 ± 22.8 N, 206.6 ± 49.8 N, and 15.9 ± 5.6 N/mm, respectively. There were no significant differences between measures in the intact and interference screw specimens. Mean failure strength and stiffness of the bone tunnel specimens were significantly lower than those of the intact and interference screw specimens; there was no significant difference between the maximum strengths of the treatments. Interference screw failure occurred abruptly with little plastic deformation in nearly all specimens with the tendon and screw pulling out as a unit, often involving fracture of the radial wall. Two of the bone tunnels failed at the bony bridge; the remainder lost bone-tendon contact as the distal tendon was shredded by the suture.
Conclusion
The results suggest interference screw fixation repair is nearly as strong and stiff as the intact tendon and stronger than the bone tunnel repair technique.
Clinical Relevance
The interference screw provides better stiffness and failure strength compared with the bone tunnel technique for distal biceps tendon repair. Given the superior mechanical properties, the interference screw technique is recommended as the treatment of choice for biceps tendon rupture repair. |
| doi_str_mv | 10.1177/0363546505284185 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_67994355</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A146061889</galeid><sage_id>10.1177_0363546505284185</sage_id><sourcerecordid>A146061889</sourcerecordid><originalsourceid>FETCH-LOGICAL-c442t-74b55d50265b6d228eedb9ad7220a43a36686751865a6a5edaefcd5f861e603c3</originalsourceid><addsrcrecordid>eNqF0U1rGzEQBmBRWhon6b1QCKalvW2qkTQj6Zg6zQcEAiU9C1k7Gzasd53VGtp_XxkbDIHQkw7zjDSjV4iPIM8BrP0uNWk0hBKVM-DwjZgBoqq0JnwrZttyta0fieOcn6SUYMm9F0dAxpIHNxOfLts8xW7-o028zvMH7uuhn__idWzHU_GuiV3mD_vzRPy--vmwuKnu7q9vFxd3VTJGTZU1S8QapSJcUq2UY66XPtZWKRmNjprIkUVwhJEich25STU2joBJ6qRPxLfdvetxeN5wnsKqzYm7LvY8bHIg673RiP-FUJ60mqDAzy_g07AZ-7JEUGClRWltQV9eQ-Ctlx7JyKKqnXqMHYe2T0M_8Z8pDV3HjxzKRyzuwwUYkgTO-eLlzqdxyHnkJqzHdhXHvwFk2IYWXoZWWs72g2yWK64PDfuUCvi6BzGn2DVj7FObD866Eq31h1lzLKMdtnnt4X_OyaWO</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1979095640</pqid></control><display><type>article</type><title>Distal Biceps Tendon Repair: A Biomechanical Comparison of Intact Tendon and 2 Repair Techniques</title><source>SAGE Publications</source><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Idler, Cary S. ; Montgomery, William H. ; Lindsey, Derek P. ; Badua, Peter A. ; Wynne, Garnet F. ; Yerby, Scott A.</creator><creatorcontrib>Idler, Cary S. ; Montgomery, William H. ; Lindsey, Derek P. ; Badua, Peter A. ; Wynne, Garnet F. ; Yerby, Scott A.</creatorcontrib><description>Background
A variety of techniques have been described for distal biceps tendon reattachment—bone tunnel with transosseous sutures, suture anchors, and interference screw techniques.
Hypothesis
There will be no significant difference between the mean failure strength, maximum strength, and stiffness of the intact specimen and repair techniques tested: bone tunnel with transosseous sutures and interference screw.
Study Design
Controlled laboratory study.
Methods
Nine matched pairs of fresh-frozen human cadaveric elbows were prepared. The intact tendon was pulled from the radial tuberosity; the right and left elbows were randomized to bone tunnels with transosseous sutures or interference screw repair techniques. The repaired specimens were pulled using the same regimen for the intact tendon. Failure strength, maximum strength, and stiffness were measured and compared.
Results
The mean failure strength, maximum strength, and stiffness of intact tendons were 204.3 ± 76.9 N, 221.7 ± 65.9 N, and 30.1 ± 12.4 N/mm, respectively; for the interference screw specimens, 178.0 ± 54.5 N, 192.1 ± 53.1 N, and 30.4 ± 9.5 N/mm, respectively; and for the bone tunnel specimens, 124.9 ± 22.8 N, 206.6 ± 49.8 N, and 15.9 ± 5.6 N/mm, respectively. There were no significant differences between measures in the intact and interference screw specimens. Mean failure strength and stiffness of the bone tunnel specimens were significantly lower than those of the intact and interference screw specimens; there was no significant difference between the maximum strengths of the treatments. Interference screw failure occurred abruptly with little plastic deformation in nearly all specimens with the tendon and screw pulling out as a unit, often involving fracture of the radial wall. Two of the bone tunnels failed at the bony bridge; the remainder lost bone-tendon contact as the distal tendon was shredded by the suture.
Conclusion
The results suggest interference screw fixation repair is nearly as strong and stiff as the intact tendon and stronger than the bone tunnel repair technique.
Clinical Relevance
The interference screw provides better stiffness and failure strength compared with the bone tunnel technique for distal biceps tendon repair. Given the superior mechanical properties, the interference screw technique is recommended as the treatment of choice for biceps tendon rupture repair.</description><identifier>ISSN: 0363-5465</identifier><identifier>EISSN: 1552-3365</identifier><identifier>DOI: 10.1177/0363546505284185</identifier><identifier>PMID: 16476918</identifier><identifier>CODEN: AJSMDO</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Aged ; Aged, 80 and over ; Arms ; Arthroplasty - methods ; Biological and medical sciences ; Biomechanical Phenomena ; Care and treatment ; Comparative analysis ; Diseases of the osteoarticular system ; Elbow ; Elbow injuries ; Elbow Joint - surgery ; Female ; Humans ; Injuries ; Injuries of the limb. Injuries of the spine ; Knee ; Male ; Medical sciences ; Middle Aged ; Muscular system ; Risk factors ; Skin & tissue grafts ; Sports injuries ; Sports medicine ; Surgery ; Tendon injuries ; Tendon Injuries - surgery ; Tendon repair ; Tendons ; Traumas. Diseases due to physical agents</subject><ispartof>The American journal of sports medicine, 2006-06, Vol.34 (6), p.968-974</ispartof><rights>2006 American Orthopaedic Society for Sports Medicine</rights><rights>2006 INIST-CNRS</rights><rights>COPYRIGHT 2006 Sage Publications, Inc.</rights><rights>Copyright Sage Publications Ltd. Jun 2006</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c442t-74b55d50265b6d228eedb9ad7220a43a36686751865a6a5edaefcd5f861e603c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0363546505284185$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0363546505284185$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17800079$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16476918$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Idler, Cary S.</creatorcontrib><creatorcontrib>Montgomery, William H.</creatorcontrib><creatorcontrib>Lindsey, Derek P.</creatorcontrib><creatorcontrib>Badua, Peter A.</creatorcontrib><creatorcontrib>Wynne, Garnet F.</creatorcontrib><creatorcontrib>Yerby, Scott A.</creatorcontrib><title>Distal Biceps Tendon Repair: A Biomechanical Comparison of Intact Tendon and 2 Repair Techniques</title><title>The American journal of sports medicine</title><addtitle>Am J Sports Med</addtitle><description>Background
A variety of techniques have been described for distal biceps tendon reattachment—bone tunnel with transosseous sutures, suture anchors, and interference screw techniques.
Hypothesis
There will be no significant difference between the mean failure strength, maximum strength, and stiffness of the intact specimen and repair techniques tested: bone tunnel with transosseous sutures and interference screw.
Study Design
Controlled laboratory study.
Methods
Nine matched pairs of fresh-frozen human cadaveric elbows were prepared. The intact tendon was pulled from the radial tuberosity; the right and left elbows were randomized to bone tunnels with transosseous sutures or interference screw repair techniques. The repaired specimens were pulled using the same regimen for the intact tendon. Failure strength, maximum strength, and stiffness were measured and compared.
Results
The mean failure strength, maximum strength, and stiffness of intact tendons were 204.3 ± 76.9 N, 221.7 ± 65.9 N, and 30.1 ± 12.4 N/mm, respectively; for the interference screw specimens, 178.0 ± 54.5 N, 192.1 ± 53.1 N, and 30.4 ± 9.5 N/mm, respectively; and for the bone tunnel specimens, 124.9 ± 22.8 N, 206.6 ± 49.8 N, and 15.9 ± 5.6 N/mm, respectively. There were no significant differences between measures in the intact and interference screw specimens. Mean failure strength and stiffness of the bone tunnel specimens were significantly lower than those of the intact and interference screw specimens; there was no significant difference between the maximum strengths of the treatments. Interference screw failure occurred abruptly with little plastic deformation in nearly all specimens with the tendon and screw pulling out as a unit, often involving fracture of the radial wall. Two of the bone tunnels failed at the bony bridge; the remainder lost bone-tendon contact as the distal tendon was shredded by the suture.
Conclusion
The results suggest interference screw fixation repair is nearly as strong and stiff as the intact tendon and stronger than the bone tunnel repair technique.
Clinical Relevance
The interference screw provides better stiffness and failure strength compared with the bone tunnel technique for distal biceps tendon repair. Given the superior mechanical properties, the interference screw technique is recommended as the treatment of choice for biceps tendon rupture repair.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Arms</subject><subject>Arthroplasty - methods</subject><subject>Biological and medical sciences</subject><subject>Biomechanical Phenomena</subject><subject>Care and treatment</subject><subject>Comparative analysis</subject><subject>Diseases of the osteoarticular system</subject><subject>Elbow</subject><subject>Elbow injuries</subject><subject>Elbow Joint - surgery</subject><subject>Female</subject><subject>Humans</subject><subject>Injuries</subject><subject>Injuries of the limb. Injuries of the spine</subject><subject>Knee</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Muscular system</subject><subject>Risk factors</subject><subject>Skin & tissue grafts</subject><subject>Sports injuries</subject><subject>Sports medicine</subject><subject>Surgery</subject><subject>Tendon injuries</subject><subject>Tendon Injuries - surgery</subject><subject>Tendon repair</subject><subject>Tendons</subject><subject>Traumas. Diseases due to physical agents</subject><issn>0363-5465</issn><issn>1552-3365</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqF0U1rGzEQBmBRWhon6b1QCKalvW2qkTQj6Zg6zQcEAiU9C1k7Gzasd53VGtp_XxkbDIHQkw7zjDSjV4iPIM8BrP0uNWk0hBKVM-DwjZgBoqq0JnwrZttyta0fieOcn6SUYMm9F0dAxpIHNxOfLts8xW7-o028zvMH7uuhn__idWzHU_GuiV3mD_vzRPy--vmwuKnu7q9vFxd3VTJGTZU1S8QapSJcUq2UY66XPtZWKRmNjprIkUVwhJEich25STU2joBJ6qRPxLfdvetxeN5wnsKqzYm7LvY8bHIg673RiP-FUJ60mqDAzy_g07AZ-7JEUGClRWltQV9eQ-Ctlx7JyKKqnXqMHYe2T0M_8Z8pDV3HjxzKRyzuwwUYkgTO-eLlzqdxyHnkJqzHdhXHvwFk2IYWXoZWWs72g2yWK64PDfuUCvi6BzGn2DVj7FObD866Eq31h1lzLKMdtnnt4X_OyaWO</recordid><startdate>20060601</startdate><enddate>20060601</enddate><creator>Idler, Cary S.</creator><creator>Montgomery, William H.</creator><creator>Lindsey, Derek P.</creator><creator>Badua, Peter A.</creator><creator>Wynne, Garnet F.</creator><creator>Yerby, Scott A.</creator><general>SAGE Publications</general><general>American Orthopaedic Society for Sports Medicine</general><general>Sage Publications, Inc</general><general>Sage Publications Ltd</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>20060601</creationdate><title>Distal Biceps Tendon Repair</title><author>Idler, Cary S. ; Montgomery, William H. ; Lindsey, Derek P. ; Badua, Peter A. ; Wynne, Garnet F. ; Yerby, Scott A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-74b55d50265b6d228eedb9ad7220a43a36686751865a6a5edaefcd5f861e603c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Arms</topic><topic>Arthroplasty - methods</topic><topic>Biological and medical sciences</topic><topic>Biomechanical Phenomena</topic><topic>Care and treatment</topic><topic>Comparative analysis</topic><topic>Diseases of the osteoarticular system</topic><topic>Elbow</topic><topic>Elbow injuries</topic><topic>Elbow Joint - surgery</topic><topic>Female</topic><topic>Humans</topic><topic>Injuries</topic><topic>Injuries of the limb. Injuries of the spine</topic><topic>Knee</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Muscular system</topic><topic>Risk factors</topic><topic>Skin & tissue grafts</topic><topic>Sports injuries</topic><topic>Sports medicine</topic><topic>Surgery</topic><topic>Tendon injuries</topic><topic>Tendon Injuries - surgery</topic><topic>Tendon repair</topic><topic>Tendons</topic><topic>Traumas. Diseases due to physical agents</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Idler, Cary S.</creatorcontrib><creatorcontrib>Montgomery, William H.</creatorcontrib><creatorcontrib>Lindsey, Derek P.</creatorcontrib><creatorcontrib>Badua, Peter A.</creatorcontrib><creatorcontrib>Wynne, Garnet F.</creatorcontrib><creatorcontrib>Yerby, Scott A.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of sports medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Idler, Cary S.</au><au>Montgomery, William H.</au><au>Lindsey, Derek P.</au><au>Badua, Peter A.</au><au>Wynne, Garnet F.</au><au>Yerby, Scott A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Distal Biceps Tendon Repair: A Biomechanical Comparison of Intact Tendon and 2 Repair Techniques</atitle><jtitle>The American journal of sports medicine</jtitle><addtitle>Am J Sports Med</addtitle><date>2006-06-01</date><risdate>2006</risdate><volume>34</volume><issue>6</issue><spage>968</spage><epage>974</epage><pages>968-974</pages><issn>0363-5465</issn><eissn>1552-3365</eissn><coden>AJSMDO</coden><abstract>Background
A variety of techniques have been described for distal biceps tendon reattachment—bone tunnel with transosseous sutures, suture anchors, and interference screw techniques.
Hypothesis
There will be no significant difference between the mean failure strength, maximum strength, and stiffness of the intact specimen and repair techniques tested: bone tunnel with transosseous sutures and interference screw.
Study Design
Controlled laboratory study.
Methods
Nine matched pairs of fresh-frozen human cadaveric elbows were prepared. The intact tendon was pulled from the radial tuberosity; the right and left elbows were randomized to bone tunnels with transosseous sutures or interference screw repair techniques. The repaired specimens were pulled using the same regimen for the intact tendon. Failure strength, maximum strength, and stiffness were measured and compared.
Results
The mean failure strength, maximum strength, and stiffness of intact tendons were 204.3 ± 76.9 N, 221.7 ± 65.9 N, and 30.1 ± 12.4 N/mm, respectively; for the interference screw specimens, 178.0 ± 54.5 N, 192.1 ± 53.1 N, and 30.4 ± 9.5 N/mm, respectively; and for the bone tunnel specimens, 124.9 ± 22.8 N, 206.6 ± 49.8 N, and 15.9 ± 5.6 N/mm, respectively. There were no significant differences between measures in the intact and interference screw specimens. Mean failure strength and stiffness of the bone tunnel specimens were significantly lower than those of the intact and interference screw specimens; there was no significant difference between the maximum strengths of the treatments. Interference screw failure occurred abruptly with little plastic deformation in nearly all specimens with the tendon and screw pulling out as a unit, often involving fracture of the radial wall. Two of the bone tunnels failed at the bony bridge; the remainder lost bone-tendon contact as the distal tendon was shredded by the suture.
Conclusion
The results suggest interference screw fixation repair is nearly as strong and stiff as the intact tendon and stronger than the bone tunnel repair technique.
Clinical Relevance
The interference screw provides better stiffness and failure strength compared with the bone tunnel technique for distal biceps tendon repair. Given the superior mechanical properties, the interference screw technique is recommended as the treatment of choice for biceps tendon rupture repair.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>16476918</pmid><doi>10.1177/0363546505284185</doi><tpages>7</tpages></addata></record> |
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| subjects | Aged Aged, 80 and over Arms Arthroplasty - methods Biological and medical sciences Biomechanical Phenomena Care and treatment Comparative analysis Diseases of the osteoarticular system Elbow Elbow injuries Elbow Joint - surgery Female Humans Injuries Injuries of the limb. Injuries of the spine Knee Male Medical sciences Middle Aged Muscular system Risk factors Skin & tissue grafts Sports injuries Sports medicine Surgery Tendon injuries Tendon Injuries - surgery Tendon repair Tendons Traumas. Diseases due to physical agents |
| title | Distal Biceps Tendon Repair: A Biomechanical Comparison of Intact Tendon and 2 Repair Techniques |
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