Work

Biomechanical evaluation of four biceps tenodesis locations: A comparative study of ultimate failure load and tendon displacement

Year: 2025

Type: article

Abstract: INTRODUCTION/OBJECTIVES: Biceps tenodesis is a widely accepted treatment for patients with long-head biceps tendinopathy, particularly in younger, high-demand individuals. Despite its efficacy, the biomechanically optimal location for biceps tenodesis remains a subject of ongoing debate. This biomechanical study aims to compare the ultimate failure load and tendon displacement across four distinct biceps tenodesis locations in fresh-frozen human humeri to determine the strongest and most stable fixation site. METHODS: Fresh-frozen porcine tendons were fixed using interference screws at four biceps tenodesis sites (intra-articular, biceps groove, suprapectoral, and subpectoral) on six fresh-frozen human humeri. Each construct was subjected to cyclic loading (50 N-100 N for 5000 cycles), followed by continuous load increments until failure occurred. The ultimate failure load and tendon displacement were recorded. A linear mixed model was applied to account for the multilevel model testing. RESULTS: The mean ultimate failure loads for each group were as follows: intra-articular, 261.2 ± 78 N; biceps groove, 305 ± 113 N; suprapectoral, 337 ± 64 N; and subpectoral, 274.3 ± 108 N. Statistical analysis demonstrated a significant difference between the intra-articular and suprapectoral groups (p value = 0.03). No other pairwise comparisons in the subgroup analysis revealed significant differences. CONCLUSIONS: The suprapectoral location demonstrated the highest ultimate failure load, with statistically significant differences compared with the intra-articular group (p value = 0.03) but not with the biceps groove and subpectoral groups. However, the results are specific to the interference screw fixation technique. LEVEL OF EVIDENCE: III.

Source: Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine

DOI: 10.1016/j.jisako.2025.101018

Authors: Supanat Vaivoothpinyo, Prakasit Sanguanjit, Adinun Apivatgaroon, Punnawit Pinitchanon, Seksan Kukreja

Institution: Thammasat University

Language: English

Topic: Shoulder Injury and Treatment

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,000