Purpose
To evaluate the biomechanical profile of onlay distal biceps repair with an intramedullary
unicortical button versus all-suture anchors under cyclic loading and maximal load
to failure.
Methods
Twenty paired fresh-frozen human cadaveric elbows were randomized to onlay distal
biceps repair with either a single intramedullary button or with two 1.35-mm all-suture
anchors. A 1.3-mm high tensile strength tape was used in a Krackow stitch to suture
the tendons in both groups. Specimens and repair constructs were loaded for 3,000
cycles and then loaded to failure. Maximum load to failure, mode of failure, and construct
elongation were recorded.
Results
Mean (± standard deviation) maximum load to failure for the unicortical intramedullary
button and all-suture anchor repairs were 503.23 ± 141.77 N and 537.33 ± 262.13 N
(P = .696), respectively. Mean maximum displacement after 3,000 cycles (± standard deviation)
was 4.17 ± 2.05 mm in the button group and 2.06 ± 1.05 mm in the suture anchor group
(P = .014). Mode of failure in the button group was suture tape rupture in 7 specimens,
failure at the tendon–suture interface in 2 specimens, and button pullout in 1 specimen.
Anchor pullout was the mode of failure in all suture anchor specimens. There were
no tendon ruptures or radial tuberosity fractures in either group.
Conclusions
This study demonstrates that onlay distal biceps repair with 2 all-suture anchors
has similar maximum strength to repair with an intramedullary button and that both
are viable options for fixation.
Clinical Relevance
All-suture anchors and unicortical intramedullary button have similar maximum strength
at time zero. Both constructs provide suitable fixation for onlay distal biceps repair.
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Article Info
Publication History
Published online: July 27, 2021
Accepted:
June 27,
2021
Received:
March 25,
2021
See commentary on page 295Footnotes
The authors report the following potential conflicts of interest or sources of funding: This research was supported in part by an appointment to the Department of Defense (DoD), United States Research Participation Program administered by the Oak Ridge Institute for Science and Education (ORISE), United States through an interagency agreement between the U.S. Department of Energy (DoE) and the DoD. ORISE is managed by Oak Ridge Associated Universities (ORAU) under DoE contract number DE-20 SC0014664. Additionally, funding was provided for portions of this project through the Inova Health System Seed Grant program. The views expressed in this paper are those of the authors and do not reflect the official policy of the DoE, ORAU/ORISE Department of the Army/Navy/Air Force, Uniformed Services University of the Health Sciences, DoD, or the U.S. Government. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
Published by Elsevier on behalf of the Arthroscopy Association of North America
