Transfer of the long head of biceps to the conjoint tendon. A biomechanical study

Abstract

BackgroundTenodesis of the long head of biceps has been intensively investigated and various surgical options exist. The aim of this biomechanical study was to compare the maximum strength of two different techniques for biceps tenodesis. Our hypothesis was that the two procedures have the same biomechanical properties. MethodsWe performed the two different tenodesis techniques using 12 fresh frozen shoulders divided into two groups of six. In the first group, the biceps was transferred to the conjoint tendon. In the second group, an intraossous suprapectoral tenodesis was performed. After a preload of 10N, cyclical loading with a maximum of 60N and 100N with 100cycles and 0.5Hz was applied to the tendons for both groups. An axial ultimate loading to failure was conducted subsequently. ResultsNo significant differences were found in age, bone mineral density, or weight between the two groups. During the cyclical loading with 60N, one slippage of the tendon was observed in the suprapectoral group. The mean ultimate load to failure was 294.15N in the transposition group and 186.76N in the suprapectoral group, but this difference was not significant (P=0.18). InterpretationThe biomechanical results demonstrated equal biomechanical properties postoperatively for both transposition of the tendon and the current standard suprapectoral tenodesis procedure. The transposition can be performed as a primary or a salvage procedure in order to potentially reduce the proportion of patients with persistent postoperative bicipital groove pain and is comparable in strength to a standard tenodesis.